Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $269.15	Professional		$151.36	$190.55	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,071.52 / $2,041.74	Facility		$446.68	$1,071.52	$2,041.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $354.81 / $371.54	Professional		$338.84	$354.81	$371.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $416.87	Professional		$144.54	$199.53	$416.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $676.08 / $758.58	Facility		$204.17	$676.08	$758.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $436.52	Professional		$173.78	$281.84	$436.52
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $208.93	Professional		$144.54	$199.53	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $281.84 / $426.58	Facility		$107.15	$281.84	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $251.19	Professional		$123.03	$165.96	$251.19