Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.75 / $98.73 / $283.85	Facility		$53.75	$98.73	$283.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.77 / $54.01 / $147.00	Professional		$38.77	$54.01	$147.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $217.68 / $217.68 / $217.68	Professional	25	$217.68	$217.68	$217.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.69 / $53.75 / $67.19	Professional		$45.69	$53.75	$67.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.48 / $81.67 / $306.05	Facility		$62.48	$81.67	$306.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.25 / $85.75 / $102.09	Professional		$74.25	$85.75	$102.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.08 / $65.20 / $77.06	Facility		$51.08	$65.20	$77.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.15 / $66.40 / $84.12	Professional		$53.15	$66.40	$84.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.80 / $48.80 / $77.63	Professional		$48.80	$48.80	$77.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.70 / $101.02 / $263.95	Facility		$52.70	$101.02	$263.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $54.54 / $106.03	Professional		$48.28	$54.54	$106.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $67.87 / $96.25	Professional		$54.60	$67.87	$96.25
United Facility/Professional Professional Modifier Low / Median / High Price $24.32 / $57.02 / $85.53	Professional		$24.32	$57.02	$85.53