Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.84 / $61.02 / $79.73	Facility		$53.84	$61.02	$79.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.13 / $65.86 / $89.51	Professional		$52.13	$65.86	$89.51
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $94.00 / $94.00 / $94.00	Professional	25	$94.00	$94.00	$94.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.43 / $64.30 / $97.72	Professional		$43.43	$64.30	$97.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.38 / $36.15 / $42.46	Facility		$31.38	$36.15	$42.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $39.43 / $48.80	Professional		$32.86	$39.43	$48.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.98 / $63.60 / $89.04	Facility		$46.98	$63.60	$89.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.39 / $84.47 / $164.55	Professional		$70.39	$84.47	$164.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $39.00 / $152.08	Professional		$28.00	$39.00	$152.08
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $27.16 / $53.84 / $71.78	Facility		$27.16	$53.84	$71.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $51.51 / $67.77 / $90.12	Professional		$51.51	$67.77	$90.12
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $94.00 / $94.00 / $94.00	Professional	25	$94.00	$94.00	$94.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $100.56 / $145.15	Professional		$81.16	$100.56	$145.15
United Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $69.84 / $93.47	Professional		$42.64	$69.84	$93.47