Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $186.21 / $186.21	Facility		$141.25	$186.21	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $263.03	Professional		$125.89	$169.82	$263.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	25	$138.04	$138.04	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $165.96 / $204.17	Professional		$141.25	$165.96	$204.17
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $162.18 / $181.97	Professional	25	$138.04	$162.18	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $269.15 / $309.03	Facility		$194.98	$269.15	$309.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $295.12 / $309.03	Professional		$269.15	$295.12	$309.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $239.88 / $398.11	Professional		$138.04	$239.88	$398.11
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $186.21 / $467.74	Facility		$158.49	$186.21	$467.74
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $275.42	Professional		$131.83	$177.83	$275.42
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $257.04 / $398.11	Professional		$138.04	$257.04	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $199.53	Facility		$138.04	$138.04	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $251.19	Professional		$141.25	$177.83	$251.19