Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.05 / $50.05 / $50.05	Facility		$50.05	$50.05	$50.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $50.05 / $50.05	Professional		$30.65	$50.05	$50.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.87 / $55.87 / $55.87	Professional		$55.87	$55.87	$55.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.49 / $198.22 / $361.02	Facility		$99.49	$198.22	$361.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.44 / $65.73 / $88.74	Professional		$62.44	$65.73	$88.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.72 / $42.72 / $42.72	Facility		$42.72	$42.72	$42.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $52.58 / $52.58	Professional		$52.58	$52.58	$52.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.47 / $39.47 / $48.77	Facility		$39.47	$39.47	$48.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $41.55 / $54.65	Professional		$33.56	$41.55	$54.65
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $47.50 / $47.50 / $50.05	Facility		$47.50	$47.50	$50.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $50.04 / $69.01	Professional		$30.65	$50.04	$69.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $41.55 / $55.87	Professional		$33.24	$41.55	$55.87
United Facility/Professional Professional Modifier Low / Median / High Price $21.82 / $30.86 / $47.05	Professional		$21.82	$30.86	$47.05