Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.80 / $82.80 / $82.80	Facility		$82.80	$82.80	$82.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $82.80 / $93.96	Professional		$69.00	$82.80	$93.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.74 / $144.99 / $144.99	Professional		$108.74	$144.99	$144.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $219.45 / $437.23 / $796.34	Facility		$219.45	$437.23	$796.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.74 / $144.99 / $195.74	Professional		$137.74	$144.99	$195.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.24 / $94.24 / $114.34	Facility		$94.24	$94.24	$114.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.99 / $115.99 / $115.99	Professional		$115.99	$115.99	$115.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $128.85 / $128.85	Facility		$126.00	$128.85	$128.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $128.85 / $168.00	Professional		$109.52	$128.85	$168.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $82.80 / $104.77 / $104.77	Facility		$82.80	$104.77	$104.77
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $51.37 / $104.77 / $147.88	Professional		$51.37	$104.77	$147.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.97 / $107.29 / $123.38	Professional		$87.97	$107.29	$123.38
United Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $72.34 / $111.46	Professional		$60.28	$72.34	$111.46