Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.47 / $115.47 / $268.16	Facility		$115.47	$115.47	$268.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.94 / $112.90 / $124.19	Professional		$101.94	$112.90	$124.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.63 / $151.63 / $151.63	Professional		$151.63	$151.63	$151.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $306.02 / $609.72 / $1,110.51	Facility		$306.02	$609.72	$1,110.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.08 / $202.19 / $272.95	Professional		$192.08	$202.19	$272.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.25 / $197.31 / $300.31	Facility		$128.25	$197.31	$300.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $161.75 / $262.85 / $284.68	Professional		$161.75	$262.85	$284.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.02 / $127.07 / $127.07	Facility		$106.02	$127.07	$127.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.76 / $168.12 / $292.97	Professional		$92.76	$168.12	$292.97
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.52 / $115.47 / $268.16	Facility		$70.52	$115.47	$268.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.52 / $115.47 / $202.19	Professional		$70.52	$115.47	$202.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $127.17 / $149.62 / $172.06	Professional		$127.17	$149.62	$172.06
United Facility/Professional Professional Modifier Low / Median / High Price $70.43 / $94.95 / $158.25	Professional		$70.43	$94.95	$158.25