Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $457.09	Professional		$91.20	$141.25	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Professional		$109.65	$109.65	$147.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $181.97 / $181.97	Professional		$169.82	$181.97	$181.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $151.36 / $223.87	Facility		$109.65	$151.36	$223.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $263.03	Professional		$109.65	$144.54	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $295.12	Professional		$97.72	$141.25	$295.12
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $117.49 / $309.03	Facility		$104.71	$117.49	$309.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $316.23	Professional		$91.20	$125.89	$316.23
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $257.04	Professional		$93.33	$128.82	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $107.15	Facility		$97.72	$97.72	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $186.21	Professional		$109.65	$134.90	$186.21