Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.08 / $186.77 / $186.77	Facility		$140.08	$186.77	$186.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.91 / $158.75 / $200.81	Professional		$136.91	$158.75	$200.81
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $139.07 / $139.07 / $139.07	Professional	25	$139.07	$139.07	$139.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.88 / $268.36 / $308.61	Facility		$193.88	$268.36	$308.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.37 / $269.91 / $300.22	Professional		$245.37	$269.91	$300.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $235.99 / $235.99 / $235.99	Facility		$235.99	$235.99	$235.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.47 / $239.65 / $395.80	Professional		$138.47	$239.65	$395.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $158.75 / $186.77 / $186.77	Facility		$158.75	$186.77	$186.77
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $140.08 / $177.26 / $246.53	Professional		$140.08	$177.26	$246.53
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $139.07 / $139.07 / $139.07	Professional	25	$139.07	$139.07	$139.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.77 / $197.36 / $232.57	Professional		$184.77	$197.36	$232.57
United Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $178.01 / $260.02	Professional		$140.00	$178.01	$260.02