Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.21 / $282.45 / $324.79	Facility		$100.21	$282.45	$324.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.53 / $80.87 / $100.22	Professional		$34.53	$80.87	$100.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.47 / $111.27 / $251.37	Facility		$80.47	$111.27	$251.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.49 / $193.21 / $232.23	Professional		$176.49	$193.21	$232.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.02 / $36.02 / $60.10	Facility		$36.02	$36.02	$60.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.00 / $54.75 / $115.03	Professional		$23.00	$54.75	$115.03
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $36.02 / $194.68 / $337.51	Facility		$36.02	$194.68	$337.51
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $40.34 / $102.88	Professional		$36.02	$40.34	$102.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $32.57 / $43.57 / $76.70	Professional		$32.57	$43.57	$76.70