Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $426.58 / $831.76	Facility		$177.83	$426.58	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $524.81	Professional		$123.03	$208.93	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $398.11	Professional		$173.78	$251.19	$398.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $933.25 / $1,778.28	Facility		$398.11	$933.25	$1,778.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $331.13	Professional		$309.03	$309.03	$331.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $398.11 / $707.95	Facility		$213.80	$398.11	$707.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $436.52 / $467.74	Professional		$331.13	$436.52	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $288.40	Facility		$213.80	$213.80	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $363.08	Professional		$154.88	$213.80	$363.08
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $275.42 / $524.81	Facility		$117.49	$275.42	$524.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $199.53 / $407.38	Professional		$97.72	$199.53	$407.38
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $288.40	Facility		$213.80	$213.80	$288.40
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $288.40	Professional		$154.88	$213.80	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $251.19 / $426.58	Facility		$109.65	$251.19	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $245.47	Professional		$123.03	$147.91	$245.47