Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.15 / $86.15 / $86.15	Facility		$86.15	$86.15	$86.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.50 / $76.59 / $86.15	Professional		$55.50	$76.59	$86.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.30 / $101.30 / $101.30	Professional		$101.30	$101.30	$101.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $381.18 / $381.18 / $499.16	Facility		$381.18	$381.18	$499.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $98.74 / $140.32	Professional		$8.00	$98.74	$140.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.75 / $66.94 / $93.46	Facility		$6.75	$66.94	$93.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.31 / $62.37 / $115.02	Professional		$8.31	$62.37	$115.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.45 / $66.45 / $88.97	Facility		$66.45	$66.45	$88.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $84.69 / $92.30	Professional		$66.45	$84.69	$92.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $10.39 / $83.15 / $135.08	Professional		$10.39	$83.15	$135.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.20 / $54.47 / $87.86	Professional		$7.20	$54.47	$87.86
United Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $68.73 / $119.40	Professional		$43.22	$68.73	$119.40