Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $1,513.56 / $4,897.79	Facility		$89.13	$1,513.56	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $134.90 / $371.54	Professional		$53.70	$134.90	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $74.13 / $181.97	Professional		$42.66	$74.13	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $67.61 / $67.61	Facility		$11.75	$67.61	$67.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $69.18 / $199.53	Professional		$41.69	$69.18	$199.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $70.79 / $95.50	Facility		$52.48	$70.79	$95.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $389.05	Professional		$173.78	$223.87	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $144.54 / $354.81	Professional		$60.26	$144.54	$354.81
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,479.11 / $4,897.79	Facility		$141.25	$1,479.11	$4,897.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $154.88 / $302.00	Professional		$57.54	$154.88	$302.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $144.54 / $281.84	Professional		$57.54	$144.54	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,621.81 / $4,073.80	Facility		$436.52	$1,621.81	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $134.90 / $251.19	Professional		$57.54	$134.90	$251.19