Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.47 / $253.42 / $311.69	Facility		$53.47	$253.42	$311.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $53.47 / $53.47	Professional		$46.22	$53.47	$53.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.22 / $70.22 / $70.22	Professional		$70.22	$70.22	$70.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.69 / $282.32 / $514.20	Facility		$141.69	$282.32	$514.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.94 / $93.62 / $126.39	Professional		$88.94	$93.62	$126.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.90 / $60.85 / $73.18	Facility		$59.90	$60.85	$73.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $74.90 / $74.90	Professional		$74.90	$74.90	$74.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.55 / $60.55 / $60.55	Facility		$60.55	$60.55	$60.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.55 / $60.55 / $108.38	Professional		$60.55	$60.55	$108.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.65 / $253.42 / $311.69	Facility		$67.65	$253.42	$311.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $67.65 / $101.53	Professional		$50.29	$67.65	$101.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.80 / $69.28 / $79.67	Professional		$56.80	$69.28	$79.67
United Facility/Professional Facility Modifier Low / Median / High Price $100.35 / $118.06 / $118.06	Facility		$100.35	$118.06	$118.06
United Facility/Professional Professional Modifier Low / Median / High Price $35.64 / $44.18 / $67.59	Professional		$35.64	$44.18	$67.59