Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.67 / $99.67 / $125.58	Facility		$99.67	$99.67	$125.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $88.01 / $248.54	Professional		$77.62	$88.01	$248.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.97 / $85.19 / $154.94	Professional		$74.97	$85.19	$154.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.98 / $127.98 / $127.98	Facility		$127.98	$127.98	$127.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.35 / $136.30 / $159.97	Professional		$116.35	$136.30	$159.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.62 / $102.92 / $135.25	Facility		$80.62	$102.92	$135.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.12 / $108.84 / $132.78	Professional		$84.12	$108.84	$132.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.30 / $96.20 / $216.31	Professional		$68.30	$96.20	$216.31
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $82.17 / $85.19 / $125.58	Facility		$82.17	$85.19	$125.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $78.43 / $94.49 / $248.54	Professional		$78.43	$94.49	$248.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.97 / $98.04 / $133.67	Professional		$80.97	$98.04	$133.67
United Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $93.06 / $139.57	Professional		$72.70	$93.06	$139.57