Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.44 / $114.44 / $114.44	Facility		$114.44	$114.44	$114.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $96.79 / $114.44	Professional		$74.56	$96.79	$114.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.41 / $212.42 / $258.66	Facility		$144.41	$212.42	$258.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.87 / $151.63 / $173.29	Professional		$128.87	$151.63	$173.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.82 / $98.82 / $164.88	Facility		$98.82	$98.82	$164.88
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 $81.48 / $107.71 / $292.41	Professional		$81.48	$107.71	$292.41
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $98.82 / $98.82 / $114.44	Facility		$98.82	$98.82	$114.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $103.43 / $132.53	Professional		$92.03	$103.43	$132.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $100.71 / $141.59	Professional		$82.26	$100.71	$141.59
United Facility/Professional Facility Modifier Low / Median / High Price $105.14 / $105.14 / $105.14	Facility		$105.14	$105.14	$105.14
United Facility/Professional Professional Modifier Low / Median / High Price $76.14 / $111.03 / $147.78	Professional		$76.14	$111.03	$147.78