Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.59 / $27.59 / $27.59	Facility		$27.59	$27.59	$27.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.26 / $23.00 / $27.59	Professional		$11.26	$23.00	$27.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $36.24 / $36.24	Professional		$30.00	$36.24	$36.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.85 / $110.26 / $199.04	Facility		$54.85	$110.26	$199.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $36.24 / $48.92	Professional		$34.43	$36.24	$48.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.56 / $23.56 / $23.56	Facility		$23.56	$23.56	$23.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $28.99 / $28.99	Professional		$28.99	$28.99	$28.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.26 / $24.26 / $24.26	Facility		$24.26	$24.26	$24.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $24.26 / $42.00	Professional		$21.39	$24.26	$42.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $26.19 / $26.19 / $27.59	Facility		$26.19	$26.19	$27.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $12.39 / $27.58 / $37.24	Professional		$12.39	$27.58	$37.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.79 / $26.82 / $30.84	Professional		$22.79	$26.82	$30.84
United Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $17.32 / $27.21	Professional		$13.56	$17.32	$27.21