Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.50 / $135.50 / $299.63	Facility		$135.50	$135.50	$299.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.84 / $103.88 / $135.50	Professional		$99.84	$103.88	$135.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.55 / $192.55 / $192.55	Professional		$192.55	$192.55	$192.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.70 / $161.33 / $283.35	Facility		$115.70	$161.33	$283.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.62 / $106.97 / $114.46	Professional		$101.62	$106.97	$114.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $211.84 / $342.31	Facility		$142.63	$211.84	$342.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $178.29 / $192.55	Professional		$142.63	$178.29	$192.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.53 / $79.94 / $198.46	Professional		$67.53	$79.94	$198.46
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $135.50 / $169.38 / $359.42	Facility		$135.50	$169.38	$359.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $103.88 / $136.91 / $171.15	Professional		$103.88	$136.91	$171.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.10 / $129.91 / $212.58	Professional		$118.10	$129.91	$212.58
United Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $85.58 / $142.63	Professional		$59.90	$85.58	$142.63