Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.46 / $42.46 / $42.46	Facility		$42.46	$42.46	$42.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.76 / $42.46 / $62.39	Professional		$33.76	$42.46	$62.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.89 / $66.89 / $66.89	Professional		$66.89	$66.89	$66.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.70 / $190.68 / $347.28	Facility		$95.70	$190.68	$347.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.07 / $63.23 / $85.36	Professional		$60.07	$63.23	$85.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.10 / $41.10 / $48.42	Facility		$41.10	$41.10	$48.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.58 / $50.58 / $50.58	Professional		$50.58	$50.58	$50.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $67.20 / $77.70	Facility		$67.20	$67.20	$77.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $67.20 / $86.38	Professional		$58.91	$67.20	$86.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $42.46 / $75.08 / $75.08	Facility		$42.46	$75.08	$75.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $42.46 / $63.23 / $82.58	Professional		$42.46	$63.23	$82.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.12 / $66.00 / $75.90	Professional		$54.12	$66.00	$75.90
United Facility/Professional Facility Modifier Low / Median / High Price $105.88 / $124.56 / $124.56	Facility		$105.88	$124.56	$124.56
United Facility/Professional Professional Modifier Low / Median / High Price $35.13 / $49.67 / $74.34	Professional		$35.13	$49.67	$74.34