Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $102.99	Facility		$87.10	$87.10	$102.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $87.10 / $105.43	Professional		$65.48	$87.10	$105.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.69 / $125.99 / $170.09	Professional		$119.69	$125.99	$170.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.55 / $58.55 / $58.55	Facility		$58.55	$58.55	$58.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.05 / $139.90 / $213.82	Professional		$129.05	$139.90	$213.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $102.88 / $126.15	Professional		$78.98	$102.88	$126.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $86.45	Professional		$30.00	$30.00	$86.45
United Facility/Professional Professional Modifier Low / Median / High Price $93.27 / $109.74 / $133.54	Professional		$93.27	$109.74	$133.54