Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.34 / $129.72 / $231.64	Facility		$113.34	$129.72	$231.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.81 / $135.05 / $197.41	Professional		$107.81	$135.05	$197.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.42 / $112.12 / $145.54	Professional		$102.42	$112.12	$145.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.75 / $172.50 / $345.00	Facility		$143.75	$172.50	$345.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $143.75 / $158.13 / $194.06	Professional		$143.75	$158.13	$194.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.84 / $162.75 / $218.89	Professional		$72.84	$162.75	$218.89
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $129.72 / $197.79 / $250.93	Facility		$129.72	$197.79	$250.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.81 / $146.79 / $230.00	Professional		$107.81	$146.79	$230.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.03 / $130.93 / $160.69	Professional		$119.03	$130.93	$160.69
United Facility/Professional Professional Modifier Low / Median / High Price $86.25 / $154.04 / $201.25	Professional		$86.25	$154.04	$201.25