Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.58 / $295.54 / $363.64	Facility		$62.58	$295.54	$363.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $62.58 / $62.58	Professional		$46.32	$62.58	$62.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.19 / $82.19 / $82.19	Professional		$82.19	$82.19	$82.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.86 / $330.45 / $601.86	Facility		$165.86	$330.45	$601.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $109.58 / $147.93	Professional		$104.10	$109.58	$147.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.43 / $71.23 / $71.64	Facility		$63.43	$71.23	$71.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.66 / $87.66 / $87.66	Professional		$87.66	$87.66	$87.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $62.81 / $62.81	Facility		$62.81	$62.81	$62.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.81 / $62.81 / $127.13	Professional		$62.81	$62.81	$127.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.19 / $295.54 / $363.64	Facility		$79.19	$295.54	$363.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $79.19 / $115.05	Professional		$55.80	$79.19	$115.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.49 / $81.09 / $93.25	Professional		$66.49	$81.09	$93.25
United Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $50.54 / $78.43	Professional		$34.17	$50.54	$78.43