Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $120.23	Professional		$64.57	$79.43	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $436.52 / $831.76	Facility		$181.97	$436.52	$831.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $144.54 / $151.36	Professional		$138.04	$144.54	$151.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
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 $66.07 / $89.13 / $169.82	Professional		$66.07	$89.13	$169.82
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $275.42 / $309.03	Facility		$81.28	$275.42	$309.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $177.83	Professional		$74.13	$114.82	$177.83
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 $66.07 / $89.13 / $95.50	Professional		$66.07	$89.13	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $114.82 / $194.98	Facility		$91.20	$114.82	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $109.65	Professional		$60.26	$72.44	$109.65