Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.07 / $166.07 / $259.07	Facility		$166.07	$166.07	$259.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $166.07 / $166.07	Professional		$104.89	$166.07	$166.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.46 / $116.46 / $122.59	Facility		$116.46	$116.46	$122.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.46 / $122.59 / $136.35	Professional		$116.46	$122.59	$136.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $259.63 / $427.22	Facility		$174.81	$259.63	$427.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $218.51 / $235.99	Professional		$174.81	$218.51	$235.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.31 / $94.99 / $243.02	Professional		$76.31	$94.99	$243.02
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $164.46 / $166.07 / $305.14	Facility		$164.46	$166.07	$305.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $164.46 / $166.07 / $209.77	Professional		$164.46	$166.07	$209.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.74 / $159.21 / $260.53	Professional		$144.74	$159.21	$260.53
United Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $104.89 / $174.81	Professional		$73.42	$104.89	$174.81