Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $181.97	Professional		$81.28	$107.15	$181.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $204.17	Professional		$154.88	$154.88	$204.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $602.56 / $1,174.90	Facility		$257.04	$602.56	$1,174.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $204.17 / $213.80	Professional		$190.55	$204.17	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $234.42	Professional		$83.18	$112.20	$234.42
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $380.19 / $426.58	Facility		$114.82	$380.19	$426.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $245.47	Professional		$102.33	$154.88	$245.47
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $120.23	Professional		$83.18	$112.20	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $162.18 / $245.47	Facility		$61.66	$162.18	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $144.54	Professional		$70.79	$95.50	$144.54