Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7.59 / $22.39 / $107.15	Facility		$7.59	$22.39	$107.15
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $61.66 / $102.33 / $512.86	Facility	25	$61.66	$102.33	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $21.38 / $58.88	Professional		$7.08	$21.38	$58.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $18.62 / $33.88 / $79.43	Professional	25	$18.62	$33.88	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $21.38 / $31.62	Professional		$8.32	$21.38	$31.62
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $18.20 / $22.39 / $30.90	Professional	25	$18.20	$22.39	$30.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $25.12 / $27.54	Facility		$23.44	$25.12	$27.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $23.99 / $39.81	Professional		$21.38	$23.99	$39.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $11.22 / $16.98	Facility		$8.32	$11.22	$16.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.92 / $48.98	Professional		$21.38	$26.92	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $134.90 / $147.91	Facility		$27.54	$134.90	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $20.42 / $39.81	Professional		$8.51	$20.42	$39.81
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $7.76 / $22.91 / $123.03	Facility		$7.76	$22.91	$123.03
Health Alliance Plan Facility/Professional Facility Modifier 25 Low / Median / High Price $61.66 / $102.33 / $707.95	Facility	25	$61.66	$102.33	$707.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $19.05 / $41.69	Professional		$7.08	$19.05	$41.69
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $18.62 / $33.11 / $74.13	Professional	25	$18.62	$33.11	$74.13
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $134.90 / $147.91	Facility		$27.54	$134.90	$147.91
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $20.42 / $33.88	Professional		$8.32	$20.42	$33.88
United Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $18.20 / $22.39	Facility		$16.22	$18.20	$22.39
United Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $18.62 / $30.20	Professional		$8.71	$18.62	$30.20