Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.42 / $68.42 / $68.42	Facility		$68.42	$68.42	$68.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.67 / $66.90 / $68.42	Professional		$46.67	$66.90	$68.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $72.23 / $72.23	Professional		$67.34	$72.23	$72.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $240.43 / $320.56 / $419.78	Facility		$240.43	$320.56	$419.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.38 / $83.04 / $118.00	Professional		$6.38	$83.04	$118.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.63 / $44.11 / $58.81	Facility		$5.63	$44.11	$58.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.99 / $52.45 / $79.78	Professional		$6.99	$52.45	$79.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $35.54 / $74.12	Facility		$35.54	$35.54	$74.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $63.02 / $74.12	Professional		$35.54	$63.02	$74.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $7.21 / $63.02 / $99.73	Professional		$7.21	$63.02	$99.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.35 / $30.00 / $63.02	Professional		$5.35	$30.00	$63.02
United Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $44.96 / $59.95	Professional		$30.53	$44.96	$59.95