Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.62 / $156.82 / $156.82	Facility		$117.62	$156.82	$156.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.84 / $133.78 / $179.03	Professional		$110.84	$133.78	$179.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $127.06 / $127.06 / $127.06	Professional	25	$127.06	$127.06	$127.06
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $129.77 / $129.77 / $129.77	Professional	25	$129.77	$129.77	$129.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $192.75 / $228.57 / $260.79	Facility		$192.75	$228.57	$260.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.36 / $244.46 / $254.24	Professional		$214.36	$244.46	$254.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $187.45 / $187.45 / $187.45	Facility		$187.45	$187.45	$187.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.06 / $192.23 / $251.78	Professional		$112.06	$192.23	$251.78
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $127.52 / $156.82 / $156.82	Facility		$127.52	$156.82	$156.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $117.62 / $145.01 / $207.00	Professional		$117.62	$145.01	$207.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $153.16 / $165.30 / $195.10	Professional		$153.16	$165.30	$195.10
United Facility/Professional Facility Modifier Low / Median / High Price $152.86 / $152.86 / $152.86	Facility		$152.86	$152.86	$152.86
United Facility/Professional Professional Modifier Low / Median / High Price $113.01 / $146.33 / $212.64	Professional		$113.01	$146.33	$212.64