Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.36 / $109.10 / $137.46	Facility		$45.36	$109.10	$137.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.32 / $109.09 / $140.01	Professional		$96.32	$109.09	$140.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.63 / $167.00 / $167.00	Professional		$153.63	$167.00	$167.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.14 / $576.10 / $1,049.27	Facility		$289.14	$576.10	$1,049.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.49 / $191.04 / $257.89	Professional		$181.49	$191.04	$257.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $121.18 / $124.18 / $124.83	Facility		$121.18	$124.18	$124.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $152.83 / $152.83 / $152.83	Professional		$152.83	$152.83	$152.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.63 / $106.63 / $121.71	Facility		$106.63	$106.63	$121.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.63 / $106.63 / $221.63	Professional		$106.63	$106.63	$221.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $45.36 / $109.10 / $138.06	Facility		$45.36	$109.10	$138.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.50 / $138.06 / $194.96	Professional		$102.50	$138.06	$194.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.92 / $141.37 / $162.57	Professional		$115.92	$141.37	$162.57
United Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $89.71 / $135.03	Professional		$70.95	$89.71	$135.03