Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.88 / $63.55 / $90.63	Facility		$51.88	$63.55	$90.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.26 / $46.12 / $64.31	Professional		$29.26	$46.12	$64.31
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $64.06 / $64.06 / $64.06	Professional	25	$64.06	$64.06	$64.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $49.72 / $74.56	Professional		$47.00	$49.72	$74.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.49 / $73.70 / $73.70	Facility		$60.49	$73.70	$73.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $73.70 / $99.50	Professional		$67.00	$73.70	$99.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.36 / $36.06 / $49.07	Facility		$34.36	$36.06	$49.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.82 / $56.88 / $72.78	Professional		$45.82	$56.88	$72.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.27 / $46.14 / $116.29	Professional		$33.27	$46.14	$116.29
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $39.96 / $51.88 / $90.63	Facility		$39.96	$51.88	$90.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $51.88 / $69.20	Professional		$34.65	$51.88	$69.20
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $64.06 / $64.06 / $64.06	Professional	25	$64.06	$64.06	$64.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.66 / $67.28 / $94.57	Professional		$53.66	$67.28	$94.57
United Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $47.77 / $68.29	Professional		$40.11	$47.77	$68.29