Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.36 / $55.77 / $74.34	Facility		$37.36	$55.77	$74.34
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $139.97 / $139.97 / $192.19	Facility	25	$139.97	$139.97	$192.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.01 / $66.18 / $129.30	Professional		$41.01	$66.18	$129.30
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $46.21 / $84.21 / $171.00	Professional	25	$46.21	$84.21	$171.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.53 / $66.92 / $92.38	Professional		$44.53	$66.92	$92.38
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $56.88 / $71.06 / $92.38	Professional	25	$56.88	$71.06	$92.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $77.48 / $257.77	Facility		$72.70	$77.48	$257.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.87 / $81.36 / $104.61	Professional		$65.87	$81.36	$104.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.21 / $57.47 / $77.44	Facility		$44.21	$57.47	$77.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.06 / $86.58 / $134.81	Professional		$69.06	$86.58	$134.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.00 / $148.00 / $148.00	Facility		$135.00	$148.00	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.81 / $69.62 / $162.71	Professional		$45.81	$69.62	$162.71
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $42.35 / $62.29 / $92.11	Facility		$42.35	$62.29	$92.11
Health Alliance Plan Facility/Professional Facility Modifier 25 Low / Median / High Price $139.97 / $139.97 / $192.19	Facility	25	$139.97	$139.97	$192.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $42.03 / $66.17 / $120.92	Professional		$42.03	$66.17	$120.92
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $56.88 / $85.11 / $143.88	Professional	25	$56.88	$85.11	$143.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $67.87 / $96.25	Professional		$54.60	$67.87	$96.25
United Facility/Professional Professional Modifier Low / Median / High Price $64.79 / $77.23 / $101.54	Professional		$64.79	$77.23	$101.54