Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $97.72 / $141.25	Facility		$37.15	$97.72	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $120.23 / $295.12	Professional		$67.61	$120.23	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $144.54	Professional		$85.11	$104.71	$144.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $173.78 / $173.78	Professional		$154.88	$173.78	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $91.20 / $123.03	Facility		$69.18	$91.20	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $239.88	Professional		$100.00	$128.82	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $229.09	Professional		$67.61	$107.15	$229.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $112.20 / $138.04	Facility		$77.62	$112.20	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $109.65 / $229.09	Professional		$66.07	$109.65	$229.09
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $100.00 / $208.93	Professional		$64.57	$100.00	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $89.13 / $107.15	Facility		$87.10	$89.13	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $100.00 / $147.91	Professional		$69.18	$100.00	$147.91