Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $2,754.23 / $4,897.79	Facility		$117.49	$2,754.23	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $169.82 / $371.54	Professional		$70.79	$169.82	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $100.00 / $194.98	Professional		$66.07	$100.00	$194.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $109.65 / $109.65	Facility		$18.62	$109.65	$109.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $281.84	Professional		$97.72	$114.82	$281.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $199.53 / $398.11	Professional		$77.62	$199.53	$398.11
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $630.96 / $4,897.79	Facility		$162.18	$630.96	$4,897.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $194.98 / $346.74	Professional		$70.79	$194.98	$346.74
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $190.55 / $331.13	Professional		$74.13	$190.55	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $2,398.83 / $5,623.41	Facility		$588.84	$2,398.83	$5,623.41
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $173.78 / $302.00	Professional		$77.62	$173.78	$302.00