Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $158.49 / $158.49	Facility		$117.49	$158.49	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $194.98	Professional		$102.33	$134.90	$194.98
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.23 / $125.89 / $389.05	Professional	25	$120.23	$125.89	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $154.88	Professional		$114.82	$131.83	$154.88
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $112.20 / $131.83 / $154.88	Professional	25	$112.20	$131.83	$154.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $229.09 / $263.03	Facility		$190.55	$229.09	$263.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $245.47	Professional		$223.87	$229.09	$245.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $251.19	Professional		$112.20	$190.55	$251.19
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $158.49 / $371.54	Facility		$131.83	$158.49	$371.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $213.80	Professional		$109.65	$144.54	$213.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $251.19	Professional		$112.20	$190.55	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $151.36	Facility		$114.82	$114.82	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $144.54 / $204.17	Professional		$114.82	$144.54	$204.17