Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $100.00 / $263.03	Facility		$52.48	$100.00	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $83.18 / $363.08	Professional		$45.71	$83.18	$363.08
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	25	$218.78	$218.78	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $53.70 / $83.18	Professional		$43.65	$53.70	$83.18
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	25	$50.12	$50.12	$50.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $81.28 / $309.03	Facility		$37.15	$81.28	$309.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $109.65	Professional		$77.62	$87.10	$109.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $67.61 / $91.20	Facility		$52.48	$67.61	$91.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $120.23	Professional		$50.12	$64.57	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $66.07	Professional		$48.98	$48.98	$66.07
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $97.72 / $263.03	Facility		$52.48	$97.72	$263.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $208.93	Professional		$44.67	$61.66	$208.93
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $61.66	Professional		$48.98	$48.98	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $42.66 / $61.66	Facility		$26.92	$42.66	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $57.54 / $85.11	Professional		$28.18	$57.54	$85.11