Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Facility		$40.74	$40.74	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $33.88 / $51.29	Professional		$18.62	$33.88	$51.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $41.69 / $54.95	Professional		$36.31	$41.69	$54.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $162.18 / $309.03	Facility		$69.18	$162.18	$309.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $53.70 / $56.23	Professional		$51.29	$53.70	$56.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $64.57 / $102.33	Facility		$35.48	$64.57	$102.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $75.86	Professional		$53.70	$75.86	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $63.10	Professional		$26.30	$36.31	$63.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $102.33 / $114.82	Facility		$40.74	$102.33	$114.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $42.66 / $66.07	Professional		$26.30	$42.66	$66.07
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $43.65	Professional		$26.30	$36.31	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $41.69 / $43.65	Facility		$22.91	$41.69	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $39.81	Professional		$20.42	$25.70	$39.81