Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $141.25 / $354.81	Facility		$100.00	$141.25	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $251.19	Professional		$93.33	$120.23	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $141.25	Professional		$28.84	$28.84	$141.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $158.49 / $281.84	Facility		$107.15	$158.49	$281.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $107.15	Professional		$102.33	$107.15	$107.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $213.80 / $354.81	Facility		$141.25	$213.80	$354.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $186.21 / $190.55	Professional		$151.36	$186.21	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $309.03	Professional		$81.28	$104.71	$309.03
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $162.18 / $398.11	Facility		$112.20	$162.18	$398.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $239.88	Professional		$104.71	$147.91	$239.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $199.53	Professional		$64.57	$89.13	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $141.25 / $169.82	Facility		$128.82	$141.25	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $104.71 / $173.78	Professional		$60.26	$104.71	$173.78