Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.17 / $107.46 / $107.46	Facility		$101.17	$107.46	$107.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.22 / $89.07 / $107.46	Professional		$70.22	$89.07	$107.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.37 / $388.50 / $786.77	Facility		$169.37	$388.50	$786.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.12 / $133.86 / $159.36	Professional		$121.12	$133.86	$159.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.61 / $89.61 / $149.51	Facility		$89.61	$89.61	$149.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.91 / $112.07 / $313.94	Professional		$78.91	$112.07	$313.94
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $89.61 / $89.61 / $107.46	Facility		$89.61	$89.61	$107.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $83.35 / $97.21 / $118.82	Professional		$83.35	$97.21	$118.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $82.26 / $98.23	Professional		$30.00	$82.26	$98.23
United Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $107.18 / $152.51	Professional		$87.14	$107.18	$152.51