Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.81 / $142.81 / $249.92	Facility		$142.81	$142.81	$249.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $142.81 / $142.81	Professional		$90.20	$142.81	$142.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.95 / $170.05 / $298.66	Facility		$121.95	$170.05	$298.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.11 / $112.75 / $120.64	Professional		$107.11	$112.75	$120.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $156.34 / $156.34 / $156.34	Facility		$156.34	$156.34	$156.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.13 / $150.33 / $338.24	Professional		$65.13	$150.33	$338.24
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $76.44 / $142.81 / $262.41	Facility		$76.44	$142.81	$262.41
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $76.44 / $135.30 / $255.56	Professional		$76.44	$135.30	$255.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.48 / $136.92 / $168.04	Professional		$124.48	$136.92	$168.04
United Facility/Professional Professional Modifier Low / Median / High Price $63.14 / $90.20 / $150.33	Professional		$63.14	$90.20	$150.33