Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.60 / $137.60 / $531.41	Facility		$137.60	$137.60	$531.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.70 / $137.60 / $137.60	Professional		$104.70	$137.60	$137.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $163.84 / $287.75	Facility		$117.49	$163.84	$287.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $108.63 / $116.23	Professional		$103.20	$108.63	$116.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $150.63 / $150.63 / $150.63	Facility		$150.63	$150.63	$150.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.34 / $118.84 / $223.51	Professional		$73.34	$118.84	$223.51
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $137.60 / $172.00 / $531.41	Facility		$137.60	$172.00	$531.41
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $118.67 / $185.73 / $208.01	Professional		$118.67	$185.73	$208.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.93 / $131.92 / $161.90	Professional		$119.93	$131.92	$161.90
United Facility/Professional Professional Modifier Low / Median / High Price $60.83 / $118.55 / $197.59	Professional		$60.83	$118.55	$197.59