Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.67 / $55.67 / $55.67	Facility		$55.67	$55.67	$55.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.84 / $55.67 / $55.67	Professional		$44.84	$55.67	$55.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.11 / $73.11 / $73.11	Professional		$73.11	$73.11	$73.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.54 / $293.95 / $535.40	Facility		$147.54	$293.95	$535.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.61 / $97.48 / $131.60	Professional		$92.61	$97.48	$131.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.97 / $63.36 / $64.86	Facility		$59.97	$63.36	$64.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $77.98 / $77.98	Professional		$77.98	$77.98	$77.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.72 / $62.72 / $62.72	Facility		$62.72	$62.72	$62.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.72 / $62.72 / $112.88	Professional		$62.72	$62.72	$112.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $55.67 / $70.45 / $70.45	Facility		$55.67	$70.45	$70.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.35 / $70.45 / $102.35	Professional		$52.35	$70.45	$102.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $72.14 / $82.96	Professional		$59.15	$72.14	$82.96
United Facility/Professional Facility Modifier Low / Median / High Price $104.56 / $123.01 / $123.01	Facility		$104.56	$123.01	$123.01
United Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $46.03 / $69.77	Professional		$37.11	$46.03	$69.77