Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.69 / $129.69 / $129.69	Facility		$129.69	$129.69	$129.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.39 / $112.40 / $129.69	Professional		$81.39	$112.40	$129.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $222.94 / $436.29 / $827.78	Facility		$222.94	$436.29	$827.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.24 / $108.60 / $205.77	Professional		$15.24	$108.60	$205.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.52 / $75.31 / $108.71	Facility		$8.52	$75.31	$108.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.19 / $91.46 / $121.94	Professional		$12.19	$91.46	$121.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.50 / $123.50 / $134.41	Facility		$123.50	$123.50	$134.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $123.50 / $167.60	Professional		$104.98	$123.50	$167.60
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $129.69 / $165.15 / $165.15	Facility		$129.69	$165.15	$165.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $15.24 / $129.69 / $167.60	Professional		$15.24	$129.69	$167.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.74 / $103.91 / $167.60	Professional		$13.74	$103.91	$167.60
United Facility/Professional Professional Modifier Low / Median / High Price $65.30 / $102.49 / $177.63	Professional		$65.30	$102.49	$177.63