Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.52 / $137.99 / $437.21	Facility		$109.52	$137.99	$437.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $107.40 / $154.16	Professional		$106.33	$107.40	$154.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.04 / $136.04 / $252.57	Professional		$136.04	$136.04	$252.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.53 / $231.92 / $441.92	Facility		$123.53	$231.92	$441.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.92 / $112.67 / $146.26	Professional		$102.92	$112.67	$146.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $202.06	Facility		$106.33	$136.04	$202.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $116.96 / $246.53	Professional		$106.33	$116.96	$246.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $211.69	Professional		$106.33	$106.33	$211.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $273.25 / $417.50	Facility		$106.33	$273.25	$417.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $109.52 / $154.16	Professional		$106.33	$109.52	$154.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $149.64 / $220.86	Professional		$106.33	$149.64	$220.86
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $118.37 / $136.13	Professional		$106.33	$118.37	$136.13