Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $69.18 / $85.11	Facility	26	$66.07	$69.18	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $208.93 / $758.58	Professional		$104.71	$208.93	$758.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $190.55	Professional		$100.00	$117.49	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $181.97	Professional		$87.10	$169.82	$181.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $74.13 / $141.25	Professional		$53.70	$74.13	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $91.20	Facility	26	$13.49	$63.10	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $338.84	Professional		$93.33	$141.25	$338.84
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $75.86 / $134.90	Facility	26	$66.07	$75.86	$134.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $151.36 / $398.11	Professional		$102.33	$151.36	$398.11
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $91.20	Facility	26	$13.49	$63.10	$91.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $263.03	Professional		$91.20	$128.82	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $181.97	Professional		$107.15	$134.90	$181.97