Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.01 / $95.76 / $146.51	Facility		$65.01	$95.76	$146.51
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $81.00 / $92.68 / $532.83	Facility	25	$81.00	$92.68	$532.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $105.47 / $247.40	Professional		$66.48	$105.47	$247.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.04 / $125.81 / $284.57	Professional	25	$72.04	$125.81	$284.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.50 / $112.15 / $189.49	Professional		$79.50	$112.15	$189.49
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $79.84 / $112.15 / $157.91	Professional	25	$79.84	$112.15	$157.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.90 / $110.47 / $281.33	Facility		$93.90	$110.47	$281.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.90 / $115.21 / $137.15	Professional		$93.90	$115.21	$137.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.43 / $100.66 / $136.31	Facility		$77.43	$100.66	$136.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.39 / $135.90 / $213.29	Professional		$107.39	$135.90	$213.29
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 $72.62 / $105.62 / $249.07	Professional		$72.62	$105.62	$249.07
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $65.01 / $95.74 / $143.65	Facility		$65.01	$95.74	$143.65
Health Alliance Plan Facility/Professional Facility Modifier 25 Low / Median / High Price $81.00 / $92.68 / $532.83	Facility	25	$81.00	$92.68	$532.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.91 / $102.58 / $185.49	Professional		$69.91	$102.58	$185.49
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $72.04 / $124.29 / $255.00	Professional	25	$72.04	$124.29	$255.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.61 / $134.94 / $192.02	Professional		$107.61	$134.94	$192.02
United Facility/Professional Professional Modifier Low / Median / High Price $92.95 / $112.26 / $147.19	Professional		$92.95	$112.26	$147.19