Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $104.71 / $165.96	Facility		$47.86	$104.71	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $371.54	Professional		$89.13	$151.36	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $165.96	Professional		$100.00	$125.89	$165.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $141.25 / $141.25	Facility		$138.04	$141.25	$141.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $151.36 / $158.49	Professional		$131.83	$151.36	$158.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $114.82 / $158.49	Facility		$89.13	$114.82	$158.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $288.40	Professional		$120.23	$154.88	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $275.42	Professional		$85.11	$128.82	$275.42
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $125.89 / $154.88	Facility		$63.10	$125.89	$154.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $275.42	Professional		$85.11	$134.90	$275.42
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $251.19	Professional		$81.28	$120.23	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $107.15 / $123.03	Facility		$100.00	$107.15	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $177.83	Professional		$89.13	$123.03	$177.83