Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.27 / $232.53 / $555.20	Facility		$74.27	$232.53	$555.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.87 / $160.99	Professional		$40.65	$41.87	$160.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $41.20 / $63.04	Professional		$41.20	$41.20	$63.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.25 / $82.87 / $187.98	Facility		$50.25	$82.87	$187.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.35 / $43.08 / $55.92	Professional		$39.35	$43.08	$55.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $41.20 / $61.80	Facility		$40.65	$41.20	$61.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.20 / $65.04	Professional		$40.65	$41.20	$65.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.92 / $163.92 / $163.92	Facility		$163.92	$163.92	$163.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $50.62	Professional		$40.65	$40.65	$50.62
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $60.97 / $188.92 / $519.63	Facility		$60.97	$188.92	$519.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.87 / $101.06	Professional		$40.65	$41.87	$101.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.88 / $61.80	Professional		$40.65	$41.88	$61.80
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $45.53	Professional		$40.65	$40.65	$45.53