Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.53 / $97.53 / $122.88	Facility		$97.53	$97.53	$122.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $94.11 / $110.82	Professional		$57.56	$94.11	$110.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.34 / $276.82 / $812.16	Facility		$160.34	$276.82	$812.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $88.78 / $163.56	Professional		$43.00	$88.78	$163.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.61 / $88.61 / $147.85	Facility		$88.61	$88.61	$147.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.50 / $53.50 / $65.00	Facility		$53.50	$53.50	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.30 / $114.94 / $325.41	Professional		$81.30	$114.94	$325.41
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $88.61 / $97.53 / $122.88	Facility		$88.61	$97.53	$122.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $79.39 / $97.53 / $129.16	Professional		$79.39	$97.53	$129.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.15 / $100.04 / $140.27	Professional		$82.15	$100.04	$140.27
United Facility/Professional Facility Modifier Low / Median / High Price $86.94 / $108.68 / $119.55	Facility		$86.94	$108.68	$119.55
United Facility/Professional Professional Modifier Low / Median / High Price $83.74 / $103.96 / $141.19	Professional		$83.74	$103.96	$141.19