Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $186.21 / $251.19	Facility		$47.86	$186.21	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $229.09 / $616.60	Professional		$141.25	$229.09	$616.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $169.82 / $316.23 / $741.31	Professional	25	$169.82	$316.23	$741.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $316.23	Professional		$158.49	$218.78	$316.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $169.82 / $218.78 / $309.03	Professional	25	$169.82	$218.78	$309.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $213.80 / $257.04	Facility		$181.97	$213.80	$257.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $309.03	Professional		$190.55	$234.42	$309.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $234.42 / $354.81	Facility		$169.82	$234.42	$354.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $489.78	Professional		$208.93	$263.03	$489.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $147.91 / $281.84	Facility		$134.90	$147.91	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $208.93 / $446.68	Professional		$158.49	$208.93	$446.68
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $190.55 / $281.84	Facility		$47.86	$190.55	$281.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $457.09	Professional		$141.25	$208.93	$457.09
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $302.00 / $676.08	Professional	25	$173.78	$302.00	$676.08
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $147.91 / $281.84	Facility		$134.90	$147.91	$281.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $199.53 / $398.11	Professional		$154.88	$199.53	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $165.96 / $181.97	Facility		$147.91	$165.96	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $302.00	Professional		$151.36	$199.53	$302.00