Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $302.00	Professional		$64.57	$95.50	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $81.28	Professional		$40.74	$40.74	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $131.83 / $165.96	Professional		$123.03	$131.83	$165.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $138.04 / $194.98	Facility		$77.62	$138.04	$194.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $213.80	Professional		$97.72	$114.82	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $67.61 / $316.23	Professional		$41.69	$67.61	$316.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $269.15	Professional		$70.79	$107.15	$269.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $131.83	Professional		$37.15	$46.77	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $131.83	Professional		$50.12	$85.11	$131.83