Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $275.42 / $398.11	Facility		$38.02	$275.42	$398.11
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $204.17 / $331.13 / $616.60	Facility	25	$204.17	$331.13	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $125.89	Professional		$30.90	$51.29	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $45.71 / $66.07	Professional		$35.48	$45.71	$66.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $70.79 / $213.80	Facility		$61.66	$70.79	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $66.07 / $70.79	Professional		$58.88	$66.07	$70.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $57.54 / $89.13	Facility		$39.81	$57.54	$89.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $97.72	Professional		$39.81	$51.29	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $134.90	Professional		$32.36	$45.71	$134.90
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $257.04 / $398.11	Facility		$37.15	$257.04	$398.11
Health Alliance Plan Facility/Professional Facility Modifier 25 Low / Median / High Price $199.53 / $331.13 / $512.86	Facility	25	$199.53	$331.13	$512.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $109.65	Professional		$32.36	$48.98	$109.65
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $117.49	Professional		$30.90	$45.71	$117.49
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $426.58	Facility		$158.49	$158.49	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $69.18	Professional		$36.31	$45.71	$69.18