Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $33.11 / $194.98	Facility		$22.91	$33.11	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $37.15 / $79.43	Professional		$19.95	$37.15	$79.43
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	25	$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.39 / $29.51	Professional		$18.20	$22.39	$29.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $42.66 / $50.12	Facility		$29.51	$42.66	$50.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.20 / $42.66	Professional		$25.12	$30.20	$42.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $24.55 / $40.74	Facility		$17.78	$24.55	$40.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.88 / $66.07	Professional		$27.54	$33.88	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $34.67 / $64.57	Professional		$19.05	$34.67	$64.57
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $33.88 / $208.93	Facility		$22.91	$33.88	$208.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $30.90 / $61.66	Professional		$19.95	$30.90	$61.66
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	25	$95.50	$95.50	$95.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.20 / $64.57	Professional		$19.05	$30.20	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $104.71 / $281.84	Facility		$39.81	$104.71	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $32.36 / $43.65	Professional		$25.12	$32.36	$43.65