Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.31 / $160.31 / $250.08	Facility		$160.31	$160.31	$250.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $160.31 / $160.31	Professional		$145.13	$160.31	$160.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.88 / $190.88 / $335.24	Facility		$136.88	$190.88	$335.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $126.56 / $135.41	Professional		$120.23	$126.56	$135.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $175.50 / $175.50 / $175.50	Facility		$175.50	$175.50	$175.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $168.75 / $379.69	Professional		$36.10	$168.75	$379.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $72.68 / $160.31 / $294.57	Facility		$72.68	$160.31	$294.57
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $72.68 / $84.30 / $202.50	Professional		$72.68	$84.30	$202.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $75.00	Professional		$30.00	$30.00	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $70.88 / $101.25 / $168.75	Professional		$70.88	$101.25	$168.75