Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Facility		$60.00	$60.00	$60.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $100.00 / $180.00	Professional		$95.00	$100.00	$180.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $188.22 / $267.48	Professional		$99.80	$188.22	$267.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $78.98	Facility		$70.00	$70.00	$78.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47,999.52 / $47,999.52 / $47,999.52	Professional		$47,999.52	$47,999.52	$47,999.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $125.00	Facility		$90.00	$90.00	$125.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $118.65 / $140.00	Professional		$90.00	$118.65	$140.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $70.00 / $110.00	Professional		$60.00	$70.00	$110.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $67.47 / $1,500.00	Professional		$30.00	$67.47	$1,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $80.00 / $85.00	Professional		$80.00	$80.00	$85.00