Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $74.13 / $363.08	Facility		$58.88	$74.13	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $134.90	Professional		$37.15	$48.98	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $44.67 / $58.88	Professional		$35.48	$44.67	$58.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $104.71 / $204.17	Facility		$53.70	$104.71	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $63.10 / $81.28	Professional		$56.23	$63.10	$81.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $46.77 / $134.90	Facility		$30.20	$46.77	$134.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $56.23 / $114.82	Professional		$47.86	$56.23	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $165.96	Professional		$48.98	$67.61	$165.96
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $128.82 / $154.88	Facility		$52.48	$128.82	$154.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $57.54 / $112.20	Professional		$38.90	$57.54	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $69.18 / $151.36	Professional		$45.71	$69.18	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,000.00 / $1,862.09	Facility		$158.49	$1,000.00	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $57.54 / $77.62	Professional		$45.71	$57.54	$77.62