Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $112.20	Professional		$57.54	$85.11	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $512.86	Facility		$141.25	$141.25	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $104.71 / $141.25	Professional		$10.72	$104.71	$141.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $81.28 / $123.03	Facility		$8.91	$81.28	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Facility		$91.20	$91.20	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $93.33 / $158.49	Professional		$91.20	$93.33	$158.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $112.20 / $169.82	Professional		$14.13	$112.20	$169.82
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Facility		$91.20	$91.20	$117.49
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $93.33 / $117.49	Professional		$91.20	$93.33	$117.49
United Facility/Professional Facility Modifier Low / Median / High Price $6.76 / $56.23 / $100.00	Facility		$6.76	$56.23	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $87.10 / $120.23	Professional		$56.23	$87.10	$120.23