Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $46.77 / $91.20	Facility		$34.67	$46.77	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $36.31 / $69.18	Professional		$25.12	$36.31	$69.18
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	25	$33.88	$33.88	$33.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $48.98	Professional		$33.11	$44.67	$48.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	25	$44.67	$44.67	$44.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Facility		$51.29	$51.29	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $51.29 / $53.70	Professional		$47.86	$51.29	$53.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $24.55 / $74.13	Facility		$23.99	$24.55	$74.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $43.65	Professional		$42.66	$42.66	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $41.69 / $87.10	Professional		$28.18	$41.69	$87.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $91.20 / $107.15	Facility		$34.67	$91.20	$107.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $63.10	Professional		$25.70	$37.15	$63.10
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	25	$33.88	$33.88	$33.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $41.69 / $87.10	Professional		$29.51	$41.69	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $39.81 / $53.70	Professional		$29.51	$39.81	$53.70