Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Facility		$34.67	$34.67	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $46.77	Professional		$25.70	$33.11	$46.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $190.55 / $363.08	Facility		$79.43	$190.55	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $63.10 / $66.07	Professional		$60.26	$63.10	$66.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Facility		$40.74	$40.74	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Facility		$34.67	$34.67	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $74.13	Professional		$25.70	$34.67	$74.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $120.23 / $134.90	Facility		$34.67	$120.23	$134.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $77.62	Professional		$30.90	$50.12	$77.62
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Facility		$34.67	$34.67	$34.67
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $37.15	Professional		$25.70	$34.67	$37.15
United Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $50.12 / $75.86	Facility		$19.05	$50.12	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $29.51 / $44.67	Professional		$21.88	$29.51	$44.67