Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $1,174.90 / $2,187.76	Facility		$288.40	$1,174.90	$2,187.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $208.93 / $602.56	Professional		$79.43	$208.93	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $169.82	Professional		$77.62	$112.20	$169.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $125.89 / $346.74	Professional		$120.23	$125.89	$346.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $104.71 / $177.83	Facility		$79.43	$104.71	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $251.19 / $281.84	Professional		$199.53	$251.19	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	52	$114.82	$114.82	$114.82
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	53	$28.84	$28.84	$28.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $229.09 / $501.19	Professional		$89.13	$229.09	$501.19
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $1,096.48 / $2,238.72	Facility		$275.42	$1,096.48	$2,238.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $239.88 / $398.11	Professional		$83.18	$239.88	$398.11
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	52	$114.82	$114.82	$114.82
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	53	$28.84	$28.84	$28.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $213.80 / $776.25	Professional		$87.10	$213.80	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,862.09 / $4,073.80	Facility		$537.03	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $229.09 / $363.08	Professional		$95.50	$229.09	$363.08