Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7.66 / $19.94 / $89.53	Facility		$7.66	$19.94	$89.53
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $61.34 / $239.40 / $545.37	Facility	25	$61.34	$239.40	$545.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.35 / $19.32 / $37.11	Professional		$7.35	$19.32	$37.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $17.17 / $27.42 / $78.91	Professional	25	$17.17	$27.42	$78.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.77 / $21.23 / $31.85	Professional		$8.77	$21.23	$31.85
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $19.26 / $22.66 / $22.66	Professional	25	$19.26	$22.66	$22.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.21 / $27.31 / $146.21	Facility		$21.21	$27.31	$146.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.19 / $24.71 / $29.41	Professional		$20.19	$24.71	$29.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.22 / $10.49 / $12.33	Facility		$8.22	$10.49	$12.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.25 / $27.55 / $42.17	Professional		$22.25	$27.55	$42.17
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 $8.52 / $20.63 / $42.50	Professional		$8.52	$20.63	$42.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $7.66 / $21.90 / $92.58	Facility		$7.66	$21.90	$92.58
Health Alliance Plan Facility/Professional Facility Modifier 25 Low / Median / High Price $64.59 / $103.49 / $545.37	Facility	25	$64.59	$103.49	$545.37
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $7.66 / $19.94 / $37.60	Professional		$7.66	$19.94	$37.60
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $12.32 / $32.09 / $87.78	Professional	25	$12.32	$32.09	$87.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $33.44 / $48.31	Professional		$26.52	$33.44	$48.31
United Facility/Professional Professional Modifier Low / Median / High Price $19.04 / $23.27 / $30.83	Professional		$19.04	$23.27	$30.83