Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.03 / $32.03 / $32.03	Facility		$32.03	$32.03	$32.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.26 / $28.83 / $32.03	Professional		$18.26	$28.83	$32.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.02 / $37.59 / $50.11	Professional		$32.02	$37.59	$50.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.68 / $132.90 / $174.04	Facility		$99.68	$132.90	$174.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.65 / $27.18 / $48.92	Professional		$2.65	$27.18	$48.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.42 / $24.27 / $39.40	Facility		$2.42	$24.27	$39.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2.90 / $21.74 / $48.50	Professional		$2.90	$21.74	$48.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.27 / $24.27 / $32.49	Facility		$24.27	$24.27	$32.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.27 / $29.53 / $39.90	Professional		$24.27	$29.53	$39.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $4.23 / $32.03 / $60.62	Professional		$4.23	$32.03	$60.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.28 / $24.74 / $39.90	Professional		$3.28	$24.74	$39.90
United Facility/Professional Facility Modifier Low / Median / High Price $2.18 / $19.48 / $29.85	Facility		$2.18	$19.48	$29.85
United Facility/Professional Professional Modifier Low / Median / High Price $16.72 / $27.34 / $36.45	Professional		$16.72	$27.34	$36.45