Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $158.49 / $213.80	Facility		$112.20	$158.49	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $144.54 / $302.00	Professional		$100.00	$144.54	$302.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	25	$446.68	$446.68	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $162.18	Professional		$95.50	$120.23	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $162.18 / $194.98	Facility		$154.88	$162.18	$194.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $165.96 / $199.53	Professional		$141.25	$165.96	$199.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $134.90 / $229.09	Facility		$100.00	$134.90	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $186.21 / $363.08	Professional		$151.36	$186.21	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $194.98	Professional		$67.61	$107.15	$194.98
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $151.36 / $251.19	Facility		$79.43	$151.36	$251.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $251.19	Professional		$107.15	$144.54	$251.19
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	25	$446.68	$446.68	$446.68
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $169.82	Professional		$67.61	$104.71	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $181.97 / $501.19	Facility		$104.71	$181.97	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $190.55	Professional		$107.15	$138.04	$190.55