Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $281.84	Professional		$151.36	$177.83	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $275.42	Professional		$251.19	$251.19	$275.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,023.29 / $1,949.84	Facility		$436.52	$1,023.29	$1,949.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $354.81	Professional		$323.59	$338.84	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $398.11	Professional		$162.18	$218.78	$398.11
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $645.65 / $724.44	Facility		$194.98	$645.65	$724.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $269.15 / $416.87	Professional		$169.82	$269.15	$416.87
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $234.42	Professional		$162.18	$218.78	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $275.42 / $436.52	Facility		$208.93	$275.42	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $162.18 / $245.47	Professional		$131.83	$162.18	$245.47