Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.49 / $249.78 / $787.52	Facility		$143.49	$249.78	$787.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $72.56 / $151.24	Professional		$57.03	$72.56	$151.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.33 / $168.47 / $299.58	Facility		$122.33	$168.47	$299.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.46 / $105.75 / $142.76	Professional		$100.46	$105.75	$142.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.77 / $97.61 / $141.88	Facility		$24.77	$97.61	$141.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.78 / $126.12 / $194.94	Professional		$36.78	$126.12	$194.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $103.97 / $159.80	Professional		$57.32	$103.97	$159.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $143.49 / $351.59 / $711.83	Facility		$143.49	$351.59	$711.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $47.20 / $62.68 / $150.66	Professional		$47.20	$62.68	$150.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $65.00	Professional		$30.00	$30.00	$65.00
United Facility/Professional Professional Modifier Low / Median / High Price $57.17 / $86.84 / $130.26	Professional		$57.17	$86.84	$130.26