Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.75 / $30.13 / $30.13	Facility		$29.75	$30.13	$30.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.94 / $25.06 / $30.13	Professional		$15.94	$25.06	$30.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.17 / $110.68 / $214.90	Facility		$50.17	$110.68	$214.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.04 / $37.59 / $47.48	Professional		$3.04	$37.59	$47.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.72 / $25.72 / $25.72	Facility		$25.72	$25.72	$25.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $31.66 / $31.66	Professional		$31.66	$31.66	$31.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.17 / $25.17 / $29.37	Facility		$25.17	$25.17	$29.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $25.17 / $48.50	Professional		$21.39	$25.17	$48.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2.86 / $28.60 / $30.13	Facility		$2.86	$28.60	$30.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2.86 / $28.60 / $1,186.92	Professional		$2.86	$28.60	$1,186.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $13.14 / $18.39 / $32.86	Professional		$13.14	$18.39	$32.86