Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $467.74 / $812.83	Facility		$199.53	$467.74	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $457.09	Professional		$138.04	$199.53	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $162.18 / $234.42	Professional		$131.83	$162.18	$234.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Facility		$251.19	$251.19	$251.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $269.15	Professional		$251.19	$251.19	$269.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $213.80	Facility		$158.49	$158.49	$213.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $380.19	Professional		$204.17	$204.17	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $371.54	Professional		$141.25	$194.98	$371.54
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $398.11 / $616.60	Facility		$199.53	$398.11	$616.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $371.54	Professional		$138.04	$199.53	$371.54
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $371.54	Professional		$128.82	$194.98	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $173.78	Facility		$134.90	$134.90	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $194.98 / $269.15	Professional		$144.54	$194.98	$269.15