Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.02 / $56.02 / $56.02	Facility		$56.02	$56.02	$56.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.52 / $56.02 / $56.02	Professional		$46.52	$56.02	$56.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $73.56 / $98.09	Professional		$73.56	$73.56	$98.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $148.46 / $295.80 / $538.75	Facility		$148.46	$295.80	$538.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.19 / $98.09 / $132.41	Professional		$93.19	$98.09	$132.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.22 / $63.76 / $64.09	Facility		$62.22	$63.76	$64.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.47 / $78.47 / $78.47	Professional		$78.47	$78.47	$78.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.58 / $66.58 / $66.58	Facility		$66.58	$66.58	$66.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.27 / $66.58 / $113.63	Professional		$66.27	$66.58	$113.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $56.02 / $70.89 / $70.89	Facility		$56.02	$70.89	$70.89
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $70.89 / $102.99	Professional		$52.68	$70.89	$102.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $72.59 / $83.47	Professional		$59.52	$72.59	$83.47
United Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $46.06 / $69.31	Professional		$34.22	$46.06	$69.31