Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.90 / $202.90 / $202.90	Facility		$202.90	$202.90	$202.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.28 / $202.90 / $202.90	Professional		$124.28	$202.90	$202.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.50 / $226.50 / $226.50	Professional		$226.50	$226.50	$226.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $266.47 / $266.47 / $266.47	Facility		$266.47	$266.47	$266.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.15 / $266.47 / $359.73	Professional		$253.15	$266.47	$359.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.21 / $173.21 / $173.21	Facility		$173.21	$173.21	$173.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $213.18 / $213.18 / $213.18	Professional		$213.18	$213.18	$213.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.39 / $178.39 / $178.39	Facility		$178.39	$178.39	$178.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.24 / $178.39 / $309.00	Professional		$157.24	$178.39	$309.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $192.56 / $192.56 / $202.90	Facility		$192.56	$192.56	$202.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $160.04 / $202.90 / $279.79	Professional		$160.04	$202.90	$279.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $167.61 / $197.19 / $226.76	Professional		$167.61	$197.19	$226.76
United Facility/Professional Professional Modifier Low / Median / High Price $99.71 / $127.39 / $204.85	Professional		$99.71	$127.39	$204.85