Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.24 / $35.00 / $168.18	Facility		$14.24	$35.00	$168.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.42 / $142.56 / $199.99	Professional		$95.42	$142.56	$199.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.53 / $96.84 / $122.11	Professional		$81.53	$96.84	$122.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.21 / $62.27 / $108.22	Facility		$45.21	$62.27	$108.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.08 / $80.97 / $106.54	Professional		$39.08	$80.97	$106.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.45 / $90.32 / $154.34	Facility		$36.45	$90.32	$154.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.79 / $100.85 / $160.22	Professional		$40.79	$100.85	$160.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.24 / $140.24 / $140.24	Facility		$140.24	$140.24	$140.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.42 / $172.45 / $290.54	Professional		$113.42	$172.45	$290.54
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $15.02 / $84.00 / $200.07	Facility		$15.02	$84.00	$200.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $119.20 / $142.56 / $179.97	Professional		$119.20	$142.56	$179.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.45 / $158.26 / $226.15	Professional		$126.45	$158.26	$226.15