Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $96.42 / $101.24	Facility		$96.42	$96.42	$101.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.83 / $96.42 / $119.81	Professional		$63.83	$96.42	$119.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $157.47 / $271.88 / $797.69	Facility		$157.47	$271.88	$797.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $88.78 / $160.63	Professional		$43.00	$88.78	$160.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.30 / $93.30 / $155.66	Facility		$93.30	$93.30	$155.66
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 $77.86 / $115.27 / $320.61	Professional		$77.86	$115.27	$320.61
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $93.30 / $96.42 / $121.48	Facility		$93.30	$96.42	$121.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $82.04 / $96.42 / $126.71	Professional		$82.04	$96.42	$126.71
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 Professional Modifier Low / Median / High Price $83.15 / $104.40 / $144.13	Professional		$83.15	$104.40	$144.13