Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $74.52 / $74.52	Facility		$74.52	$74.52	$74.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $74.52 / $74.52	Professional		$57.55	$74.52	$74.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.87 / $97.87 / $97.87	Professional		$97.87	$97.87	$97.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.51 / $393.51 / $716.70	Facility		$197.51	$393.51	$716.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.97 / $130.49 / $176.16	Professional		$123.97	$130.49	$176.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.01 / $84.82 / $88.15	Facility		$73.01	$84.82	$88.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.39 / $104.39 / $104.39	Professional		$104.39	$104.39	$104.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.80 / $75.80 / $75.80	Facility		$75.80	$75.80	$75.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.80 / $75.80 / $151.13	Professional		$75.80	$75.80	$151.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $94.30 / $94.30	Facility		$74.52	$94.30	$94.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $94.30 / $137.01	Professional		$70.09	$94.30	$137.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.17 / $96.56 / $111.04	Professional		$79.17	$96.56	$111.04
United Facility/Professional Facility Modifier Low / Median / High Price $71.80 / $71.80 / $71.80	Facility		$71.80	$71.80	$71.80
United Facility/Professional Professional Modifier Low / Median / High Price $42.08 / $60.19 / $87.19	Professional		$42.08	$60.19	$87.19