Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.44 / $137.44 / $137.44	Facility		$137.44	$137.44	$137.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.09 / $129.50 / $137.44	Professional		$85.09	$129.50	$137.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.49 / $133.49 / $133.49	Professional		$133.49	$133.49	$133.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $125.45 / $225.81	Professional		$16.73	$125.45	$225.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.35 / $109.68 / $197.44	Facility		$10.35	$109.68	$197.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.74 / $19.89 / $134.99	Professional		$12.74	$19.89	$134.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $110.00 / $112.20	Facility		$110.00	$110.00	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $133.01 / $198.10	Professional		$110.00	$133.01	$198.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $17.97 / $137.44 / $196.64	Professional		$17.97	$137.44	$196.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.65 / $61.84 / $203.18	Professional		$16.65	$61.84	$203.18
United Facility/Professional Professional Modifier Low / Median / High Price $61.35 / $97.48 / $200.74	Professional		$61.35	$97.48	$200.74