Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.41 / $280.12 / $306.07	Facility		$42.41	$280.12	$306.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.39 / $39.97 / $42.41	Professional		$34.39	$39.97	$42.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.27 / $74.27 / $74.27	Professional		$74.27	$74.27	$74.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.41 / $223.97 / $407.92	Facility		$112.41	$223.97	$407.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.56 / $74.27 / $100.26	Professional		$70.56	$74.27	$100.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.33 / $40.43 / $48.28	Facility		$39.33	$40.43	$48.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $59.42 / $59.42	Professional		$59.42	$59.42	$59.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.99 / $48.99 / $48.99	Facility		$48.99	$48.99	$48.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.99 / $48.99 / $86.25	Professional		$48.99	$48.99	$86.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $53.66 / $280.12 / $306.07	Facility		$53.66	$280.12	$306.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.01 / $53.66 / $89.12	Professional		$38.01	$53.66	$89.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.06 / $54.96 / $63.20	Professional		$45.06	$54.96	$63.20
United Facility/Professional Professional Modifier Low / Median / High Price $25.16 / $34.53 / $49.62	Professional		$25.16	$34.53	$49.62