Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.63 / $146.63 / $146.63	Facility		$146.63	$146.63	$146.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.66 / $141.10 / $146.63	Professional		$94.66	$141.10	$146.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $113.82 / $113.82	Professional		$113.82	$113.82	$113.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.59 / $139.55 / $251.18	Professional		$13.59	$139.55	$251.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.21 / $15.82 / $219.38	Facility		$11.21	$15.82	$219.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.18 / $19.47 / $201.00	Professional		$14.18	$19.47	$201.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.12 / $129.12 / $131.69	Facility		$129.12	$129.12	$131.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.12 / $132.99 / $194.10	Professional		$129.12	$132.99	$194.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $17.59 / $149.55 / $202.90	Professional		$17.59	$149.55	$202.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.28 / $83.03 / $178.57	Professional		$14.28	$83.03	$178.57
United Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $101.52 / $169.83	Professional		$66.95	$101.52	$169.83