Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.88 / $119.88 / $119.88	Facility		$119.88	$119.88	$119.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.61 / $119.88 / $119.88	Professional		$99.61	$119.88	$119.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.43 / $157.43 / $209.91	Professional		$157.43	$157.43	$209.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $317.70 / $633.00 / $1,152.91	Facility		$317.70	$633.00	$1,152.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.41 / $209.91 / $283.38	Professional		$199.41	$209.91	$283.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $133.21 / $136.44 / $137.19	Facility		$133.21	$136.44	$137.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $167.93 / $167.93 / $167.93	Professional		$167.93	$167.93	$167.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $140.54	Facility		$140.54	$140.54	$140.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $174.54 / $304.22	Professional		$102.59	$174.54	$304.22
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $119.88 / $151.69 / $151.69	Facility		$119.88	$151.69	$151.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $112.73 / $151.69 / $220.40	Professional		$112.73	$151.69	$220.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $127.37 / $155.33 / $178.62	Professional		$127.37	$155.33	$178.62
United Facility/Professional Professional Modifier Low / Median / High Price $73.26 / $98.58 / $148.40	Professional		$73.26	$98.58	$148.40