Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.87 / $121.88 / $223.95	Facility		$121.87	$121.88	$223.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $121.88 / $163.22	Professional		$67.98	$121.88	$163.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.07 / $145.12 / $254.88	Facility		$104.07	$145.12	$254.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.41 / $96.22 / $102.96	Professional		$91.41	$96.22	$102.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.29 / $190.55 / $348.36	Facility		$128.29	$190.55	$348.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.29 / $160.36 / $173.19	Professional		$128.29	$160.36	$173.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.22 / $105.06 / $195.66	Professional		$65.22	$105.06	$195.66
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $121.87 / $127.13 / $223.95	Facility		$121.87	$127.13	$223.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $121.88 / $128.29 / $200.77	Professional		$121.88	$128.29	$200.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.22 / $116.84 / $143.39	Professional		$106.22	$116.84	$143.39
United Facility/Professional Professional Modifier Low / Median / High Price $53.88 / $76.97 / $174.58	Professional		$53.88	$76.97	$174.58