Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.73 / $111.73 / $111.73	Facility		$111.73	$111.73	$111.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.94 / $111.73 / $111.73	Professional		$80.94	$111.73	$111.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $222.09 / $442.48 / $805.90	Facility		$222.09	$442.48	$805.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.38 / $146.72 / $198.09	Professional		$139.38	$146.72	$198.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.37 / $95.37 / $95.37	Facility		$95.37	$95.37	$95.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.38 / $117.38 / $117.38	Professional		$117.38	$117.38	$117.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.15 / $88.15 / $88.15	Facility		$88.15	$88.15	$88.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.47 / $88.15 / $122.01	Professional		$72.47	$88.15	$122.01
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $106.04 / $106.04 / $111.73	Facility		$106.04	$106.04	$111.73
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.14 / $111.73 / $165.04	Professional		$88.14	$111.73	$165.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.97 / $72.47 / $97.83	Professional		$57.97	$72.47	$97.83
United Facility/Professional Facility Modifier Low / Median / High Price $49.35 / $82.22 / $98.52	Facility		$49.35	$82.22	$98.52
United Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $68.91 / $103.71	Professional		$48.72	$68.91	$103.71