Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.63 / $166.63 / $469.53	Facility		$166.63	$166.63	$469.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.32 / $166.63 / $166.63	Professional		$140.32	$166.63	$166.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.28 / $198.40 / $348.46	Facility		$142.28	$198.40	$348.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.97 / $131.55 / $140.76	Professional		$124.97	$131.55	$140.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $175.40 / $210.48 / $420.96	Facility		$175.40	$210.48	$420.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $219.25 / $236.79	Professional		$175.40	$219.25	$236.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $107.65 / $243.92	Professional		$80.23	$107.65	$243.92
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $166.63 / $166.63 / $976.00	Facility		$166.63	$166.63	$976.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $149.09 / $238.54 / $976.00	Professional		$149.09	$238.54	$976.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $145.22 / $159.75 / $196.06	Professional		$145.22	$159.75	$196.06
United Facility/Professional Professional Modifier Low / Median / High Price $73.67 / $105.24 / $179.25	Professional		$73.67	$105.24	$179.25