Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.27 / $237.27 / $417.21	Facility		$128.27	$237.27	$417.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.71 / $142.63 / $213.94	Professional		$92.71	$142.63	$213.94
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 $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 $142.62 / $243.70 / $483.30	Facility		$142.62	$243.70	$483.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $142.62 / $142.63 / $242.47	Professional		$142.62	$142.63	$242.47
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 $85.58 / $145.30 / $188.89	Professional		$85.58	$145.30	$188.89