Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.28 / $16.28 / $539.14	Facility		$16.28	$16.28	$539.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.57 / $16.28 / $16.28	Professional		$13.57	$16.28	$16.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $21.39 / $21.39	Professional		$21.39	$21.39	$21.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.17 / $86.00 / $156.63	Facility		$43.17	$86.00	$156.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.09 / $28.52 / $38.50	Professional		$27.09	$28.52	$38.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.27 / $18.54 / $21.51	Facility		$17.27	$18.54	$21.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.82 / $22.82 / $22.82	Professional		$22.82	$22.82	$22.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.44 / $18.44 / $18.44	Facility		$18.44	$18.44	$18.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.44 / $18.44 / $33.00	Professional		$18.44	$18.44	$33.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $20.60 / $526.50 / $539.14	Facility		$20.60	$526.50	$539.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $15.96 / $20.60 / $29.94	Professional		$15.96	$20.60	$29.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $21.10 / $24.26	Professional		$17.30	$21.10	$24.26
United Facility/Professional Professional Modifier Low / Median / High Price $11.05 / $13.63 / $20.43	Professional		$11.05	$13.63	$20.43