Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $112.20	Professional		$56.23	$70.79	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $95.50	Professional		$75.86	$75.86	$95.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $416.87 / $794.33	Facility		$173.78	$416.87	$794.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $138.04 / $144.54	Professional		$131.83	$138.04	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $162.18	Professional		$64.57	$89.13	$162.18
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $263.03 / $295.12	Facility		$77.62	$263.03	$295.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $109.65 / $169.82	Professional		$67.61	$109.65	$169.82
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $95.50	Professional		$64.57	$89.13	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $109.65 / $165.96	Facility		$79.43	$109.65	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $95.50	Professional		$50.12	$66.07	$95.50