Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $95.50 / $120.23	Facility		$70.79	$95.50	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $263.03	Professional		$72.44	$109.65	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $138.04	Professional		$87.10	$109.65	$138.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $144.54	Professional		$131.83	$131.83	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $109.65 / $151.36	Facility		$83.18	$109.65	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $251.19	Professional		$104.71	$134.90	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $213.80	Professional		$85.11	$120.23	$213.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $120.23 / $138.04	Facility		$81.28	$120.23	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $199.53	Professional		$75.86	$114.82	$199.53
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $181.97	Professional		$81.28	$117.49	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $102.33 / $125.89	Facility		$100.00	$102.33	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $173.78	Professional		$89.13	$120.23	$173.78