Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $223.87 / $575.44	Facility		$67.61	$223.87	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $457.09	Professional		$169.82	$218.78	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $309.03 / $588.84	Professional		$295.12	$309.03	$588.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $1,174.90 / $2,238.72	Facility		$489.78	$1,174.90	$2,238.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $389.05 / $407.38	Professional		$371.54	$389.05	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $446.68 / $691.83	Facility		$239.88	$446.68	$691.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $512.86 / $524.81	Professional		$371.54	$512.86	$524.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $501.19	Professional		$169.82	$234.42	$501.19
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $295.12 / $758.58	Facility		$70.79	$295.12	$758.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $512.86	Professional		$204.17	$309.03	$512.86
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $457.09	Professional		$169.82	$234.42	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $309.03 / $501.19	Facility		$123.03	$309.03	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $338.84	Professional		$141.25	$181.97	$338.84