Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $234.42 / $239.88	Facility		$67.61	$234.42	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $77.62	Professional		$28.84	$53.70	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $89.13	Professional		$52.48	$70.79	$89.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $89.13 / $93.33	Professional		$85.11	$89.13	$93.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $107.15 / $190.55	Facility		$57.54	$107.15	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $125.89	Professional		$89.13	$123.03	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $104.71	Professional		$43.65	$58.88	$104.71
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $173.78 / $234.42	Facility		$67.61	$173.78	$234.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $69.18 / $109.65	Professional		$40.74	$69.18	$109.65
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $72.44	Professional		$43.65	$58.88	$72.44
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $67.61 / $70.79	Facility		$37.15	$67.61	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $63.10	Professional		$33.11	$42.66	$63.10