Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.93 / $145.80 / $173.65	Facility		$123.93	$145.80	$173.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $152.87 / $210.31	Professional		$115.50	$152.87	$210.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.84 / $202.76 / $271.51	Professional		$150.84	$202.76	$271.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $198.70 / $198.70 / $198.70	Facility		$198.70	$198.70	$198.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.77 / $208.64 / $268.25	Professional		$188.77	$208.64	$268.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.95 / $160.58 / $188.93	Facility		$125.95	$160.58	$188.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.38 / $195.14 / $306.02	Professional		$155.38	$195.14	$306.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $171.32 / $310.94	Professional		$125.00	$171.32	$310.94
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $123.93 / $175.68 / $202.03	Facility		$123.93	$175.68	$202.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $123.93 / $170.00 / $232.49	Professional		$123.93	$170.00	$232.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $163.89 / $247.25	Professional		$134.66	$163.89	$247.25
United Facility/Professional Professional Modifier Low / Median / High Price $165.11 / $200.38 / $251.26	Professional		$165.11	$200.38	$251.26