Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.48 / $73.48 / $128.61	Facility		$73.48	$73.48	$128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $73.48 / $215.04	Professional		$73.48	$73.48	$215.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $60.00 / $76.00	Professional		$35.00	$60.00	$76.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.85 / $57.05 / $99.33	Facility		$40.85	$57.05	$99.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $50.00 / $53.50	Professional		$47.50	$50.00	$53.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.29 / $104.40 / $168.70	Facility		$70.29	$104.40	$168.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.29 / $87.86 / $94.89	Professional		$70.29	$87.86	$94.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.47 / $91.84 / $97.66	Professional		$73.47	$91.84	$97.66
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $63.59 / $73.48 / $258.00	Facility		$63.59	$73.48	$258.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $63.59 / $73.48 / $115.17	Professional		$63.59	$73.48	$115.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.20 / $64.02 / $104.76	Professional		$58.20	$64.02	$104.76
United Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $44.98 / $82.05	Professional		$31.74	$44.98	$82.05