Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.06 / $125.61 / $330.40	Facility		$65.06	$125.61	$330.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $72.43 / $127.15	Professional		$45.13	$72.43	$127.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $156.24 / $183.83 / $183.83	Professional	50	$156.24	$183.83	$183.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.72 / $75.31 / $104.58	Professional		$51.72	$75.31	$104.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.39 / $163.72 / $374.89	Facility		$114.39	$163.72	$374.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.87 / $75.70 / $126.30	Professional		$12.87	$75.70	$126.30
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $103.22 / $121.44 / $180.56	Professional	50	$103.22	$121.44	$180.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.37 / $59.34 / $71.20	Facility		$47.37	$59.34	$71.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $90.64 / $113.92	Professional		$67.55	$90.64	$113.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.05 / $71.61 / $130.71	Professional		$48.05	$71.61	$130.71
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $65.06 / $154.60 / $372.87	Facility		$65.06	$154.60	$372.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $60.67 / $81.73 / $126.25	Professional		$60.67	$81.73	$126.25
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $156.24 / $156.24 / $183.83	Professional	50	$156.24	$156.24	$183.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $68.01 / $96.85	Professional		$54.68	$68.01	$96.85
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $81.63 / $116.04	Professional		$69.84	$81.63	$116.04