Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $892.94 / $892.94	Facility		$30.00	$892.94	$892.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.82 / $30.00 / $30.00	Professional		$22.82	$30.00	$30.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.43 / $38.04 / $38.04	Professional		$30.43	$38.04	$38.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.20 / $114.71 / $218.03	Facility		$55.20	$114.71	$218.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.14 / $39.56 / $49.45	Professional		$36.14	$39.56	$49.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.04 / $49.45 / $62.77	Facility		$38.04	$49.45	$62.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.94 / $49.45 / $88.19	Professional		$39.94	$49.45	$88.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.68 / $14.68 / $56.20	Professional		$14.68	$14.68	$56.20
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $21.11 / $443.66 / $892.94	Facility		$21.11	$443.66	$892.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $21.11 / $24.27 / $45.64	Professional		$21.11	$24.27	$45.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.36 / $33.22 / $33.22	Professional		$24.36	$33.22	$33.22
United Facility/Professional Professional Modifier Low / Median / High Price $14.77 / $22.16 / $36.93	Professional		$14.77	$22.16	$36.93