Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $163.28 / $510.30	Facility		$75.00	$163.28	$510.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.17 / $142.63 / $188.27	Professional		$74.17	$142.63	$188.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $192.55	Professional		$120.00	$120.00	$192.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.04 / $161.33 / $283.35	Facility		$112.04	$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 $69.44 / $115.20 / $178.31	Professional		$69.44	$115.20	$178.31
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $133.76 / $207.90 / $386.10	Facility		$133.76	$207.90	$386.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $142.62 / $142.63 / $188.27	Professional		$142.62	$142.63	$188.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.10 / $135.81 / $177.15	Professional		$118.10	$135.81	$177.15
United Facility/Professional Professional Modifier Low / Median / High Price $61.03 / $87.17 / $159.04	Professional		$61.03	$87.17	$159.04