Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.12 / $92.41 / $111.62	Facility		$90.12	$92.41	$111.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.21 / $23.69 / $36.08	Professional		$17.21	$23.69	$36.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.51 / $11.57 / $15.89	Professional	52	$8.51	$11.57	$15.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $26.27 / $39.72	Professional		$25.02	$26.27	$39.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $22.88 / $29.42	Professional		$20.39	$22.88	$29.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.69 / $23.54 / $24.43	Facility		$18.69	$23.54	$24.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $26.20 / $32.46	Professional		$24.95	$26.20	$32.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.29 / $21.85 / $40.86	Professional		$16.29	$21.85	$40.86
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $32.43 / $32.43 / $32.43	Professional	50	$32.43	$32.43	$32.43
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $90.12 / $92.41 / $111.62	Facility		$90.12	$92.41	$111.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.32 / $26.27 / $36.00	Professional		$19.32	$26.27	$36.00
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $9.52 / $11.82 / $15.89	Professional	52	$9.52	$11.82	$15.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.78 / $17.25 / $75.00	Professional		$12.78	$17.25	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $29.39 / $41.38	Professional		$25.02	$29.39	$41.38