Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.33 / $125.33 / $131.60	Facility		$125.33	$125.33	$131.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.69 / $115.09 / $140.41	Professional		$77.69	$115.09	$140.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $189.41 / $189.41	Facility		$63.00	$189.41	$189.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.94 / $198.88 / $236.76	Professional		$179.94	$198.88	$236.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.98 / $126.98 / $211.87	Facility		$126.98	$126.98	$211.87
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 $75.00 / $129.63 / $371.34	Professional		$75.00	$129.63	$371.34
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $125.33 / $126.98 / $131.60	Facility		$125.33	$126.98	$131.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.22 / $126.98 / $173.29	Professional		$102.22	$126.98	$173.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $129.32 / $150.94	Professional		$106.33	$129.32	$150.94