Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $83.18 / $181.97	Facility		$38.02	$83.18	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $380.19	Professional		$107.15	$158.49	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $251.19	Professional		$100.00	$125.89	$251.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $83.18 / $141.25	Facility		$56.23	$83.18	$141.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $109.65 / $117.49	Professional		$58.88	$109.65	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $131.83 / $204.17	Facility		$54.95	$131.83	$204.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $128.82 / $223.87	Professional		$52.48	$128.82	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $194.98 / $389.05	Professional		$117.49	$194.98	$389.05
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $75.86 / $181.97	Facility		$32.36	$75.86	$181.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $162.18 / $275.42	Professional		$102.33	$162.18	$275.42
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $295.12	Professional		$102.33	$158.49	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $117.49 / $162.18	Facility		$44.67	$117.49	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $257.04	Professional		$123.03	$165.96	$257.04