Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.66 / $189.42 / $237.28	Facility		$67.66	$189.42	$237.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $51.81 / $67.66	Professional		$27.60	$51.81	$67.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $88.85 / $88.85	Professional		$75.00	$88.85	$88.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.85 / $88.85 / $88.85	Facility		$88.85	$88.85	$88.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $88.85 / $119.95	Professional		$84.41	$88.85	$119.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.75 / $88.85 / $131.96	Facility		$57.75	$88.85	$131.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.08 / $115.51 / $124.39	Professional		$71.08	$115.51	$124.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.47 / $59.47 / $59.47	Facility		$59.47	$59.47	$59.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.43 / $59.47 / $103.13	Professional		$52.43	$59.47	$103.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $64.19 / $189.42 / $237.28	Facility		$64.19	$189.42	$237.28
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.37 / $67.65 / $90.78	Professional		$30.37	$67.65	$90.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.88 / $65.75 / $75.61	Professional		$55.88	$65.75	$75.61
United Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $42.47 / $66.69	Professional		$33.24	$42.47	$66.69