Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.91 / $190.91 / $190.91	Facility		$190.91	$190.91	$190.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.74 / $190.91 / $214.77	Professional		$147.74	$190.91	$214.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.08 / $829.92 / $2,021.53	Facility		$389.08	$829.92	$2,021.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.45 / $286.22 / $357.77	Professional		$261.45	$286.22	$357.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $241.93 / $326.06 / $399.18	Facility		$241.93	$326.06	$399.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $257.08 / $314.51 / $530.77	Professional		$257.08	$314.51	$530.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.94 / $160.94 / $160.94	Professional		$160.94	$160.94	$160.94
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $190.91 / $190.91 / $190.91	Facility		$190.91	$190.91	$190.91
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $189.97 / $199.80 / $362.58	Professional		$189.97	$199.80	$362.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $50.00 / $279.77	Professional		$30.00	$50.00	$279.77
United Facility/Professional Professional Modifier Low / Median / High Price $107.50 / $144.59 / $240.98	Professional		$107.50	$144.59	$240.98