Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.68 / $87.68 / $87.68	Facility		$87.68	$87.68	$87.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.63 / $87.68 / $87.68	Professional		$74.63	$87.68	$87.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.16 / $115.16 / $115.16	Professional		$115.16	$115.16	$115.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $232.39 / $463.02 / $843.30	Facility		$232.39	$463.02	$843.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.86 / $153.54 / $207.28	Professional		$145.86	$153.54	$207.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.80 / $99.80 / $103.62	Facility		$99.80	$99.80	$103.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $122.83 / $122.83 / $122.83	Professional		$122.83	$122.83	$122.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.32 / $99.32 / $99.32	Facility		$99.32	$99.32	$99.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.32 / $99.32 / $178.13	Professional		$99.32	$99.32	$178.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $87.68 / $110.96 / $110.96	Facility		$87.68	$110.96	$110.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $86.88 / $110.96 / $161.21	Professional		$86.88	$110.96	$161.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.16 / $113.62 / $130.66	Professional		$93.16	$113.62	$130.66
United Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $76.43 / $118.04	Professional		$63.84	$76.43	$118.04