Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.52 / $136.69 / $136.69	Facility		$102.52	$136.69	$136.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.52 / $119.76 / $156.03	Professional		$102.52	$119.76	$156.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.01 / $112.01 / $112.01	Professional		$112.01	$112.01	$112.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.01 / $196.56 / $226.04	Facility		$142.01	$196.56	$226.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.01 / $196.56 / $219.90	Professional		$142.01	$196.56	$219.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.81 / $186.81 / $186.81	Facility		$186.81	$186.81	$186.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $189.39 / $342.88	Professional		$108.47	$189.39	$342.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $116.18 / $136.69 / $136.69	Facility		$116.18	$136.69	$136.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.56 / $128.46 / $172.94	Professional		$102.56	$128.46	$172.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $130.87 / $153.81	Professional		$124.00	$130.87	$153.81
United Facility/Professional Professional Modifier Low / Median / High Price $106.32 / $139.91 / $194.29	Professional		$106.32	$139.91	$194.29