Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $35.00	Facility		$35.00	$35.00	$35.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.09 / $35.00 / $35.00	Professional		$29.09	$35.00	$35.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.29 / $61.29 / $61.29	Professional		$61.29	$61.29	$61.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.77 / $184.83 / $336.63	Facility		$92.77	$184.83	$336.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $61.29 / $82.74	Professional		$58.23	$61.29	$82.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $39.84 / $40.07	Facility		$38.90	$39.84	$40.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $49.03 / $49.03	Professional		$49.03	$49.03	$49.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.72 / $36.72 / $36.72	Facility		$36.72	$36.72	$36.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $36.72 / $70.88	Professional		$36.72	$36.72	$70.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $44.28 / $44.28	Facility		$35.00	$44.28	$44.28
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.28 / $64.34	Professional		$34.67	$44.28	$64.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $45.35 / $52.15	Professional		$38.54	$45.35	$52.15
United Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $28.78 / $41.82	Professional		$21.39	$28.78	$41.82