Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $354.81 / $724.44	Facility		$173.78	$354.81	$724.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $169.82 / $169.82	Professional		$158.49	$169.82	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $288.40 / $426.58	Facility		$190.55	$288.40	$426.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $223.87	Professional		$147.91	$190.55	$223.87
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $181.97 / $190.55	Facility		$162.18	$181.97	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $208.93	Professional		$169.82	$204.17	$208.93