Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.90 / $130.90 / $164.93	Facility		$130.90	$130.90	$164.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $126.79 / $193.71	Professional		$73.42	$126.79	$193.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $214.40 / $419.57 / $805.08	Facility		$214.40	$419.57	$805.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.74 / $137.84 / $172.30	Professional		$120.74	$137.84	$172.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.51 / $113.86 / $153.74	Facility		$103.51	$113.86	$153.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.62 / $114.84 / $170.47	Professional		$109.62	$114.84	$170.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $105.94 / $488.69	Professional		$67.00	$105.94	$488.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.64 / $69.64 / $130.90	Facility		$69.64	$69.64	$130.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.64 / $103.60 / $146.13	Professional		$69.64	$103.60	$146.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.29 / $100.87 / $142.08	Professional		$81.29	$100.87	$142.08
United Facility/Professional Facility Modifier Low / Median / High Price $43.30 / $99.25 / $167.19	Facility		$43.30	$99.25	$167.19
United Facility/Professional Professional Modifier Low / Median / High Price $63.14 / $100.61 / $142.04	Professional		$63.14	$100.61	$142.04