Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.81 / $120.81 / $120.81	Facility		$120.81	$120.81	$120.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.96 / $119.56 / $302.47	Professional		$92.96	$119.56	$302.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.33 / $97.33 / $97.33	Professional		$97.33	$97.33	$97.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.81 / $170.81 / $170.81	Facility		$170.81	$170.81	$170.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.28 / $179.35 / $213.51	Professional		$155.28	$179.35	$213.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.61 / $137.40 / $176.62	Facility		$108.61	$137.40	$176.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $141.19 / $178.87	Professional		$107.04	$141.19	$178.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.90 / $132.90 / $132.90	Facility		$132.90	$132.90	$132.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.11 / $140.19 / $363.00	Professional		$100.11	$140.19	$363.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $114.50 / $116.24 / $152.25	Facility		$114.50	$116.24	$152.25
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $104.54 / $120.81 / $288.52	Professional		$104.54	$120.81	$288.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $102.24 / $147.23	Professional		$81.16	$102.24	$147.23
United Facility/Professional Professional Modifier Low / Median / High Price $110.27 / $134.18 / $169.33	Professional		$110.27	$134.18	$169.33