Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Facility		$109.44	$109.44	$109.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.13 / $109.44 / $109.44	Professional		$70.13	$109.44	$109.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.66 / $261.54 / $634.73	Facility		$25.66	$261.54	$634.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.08 / $130.97 / $186.12	Professional		$10.08	$130.97	$186.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.52 / $16.23 / $162.34	Facility		$8.52	$16.23	$162.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.50 / $10.50 / $147.96	Professional		$10.50	$10.50	$147.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.91 / $114.91 / $114.91	Facility		$114.91	$114.91	$114.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $114.91 / $153.75	Professional		$10.52	$114.91	$153.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $115.54 / $115.54	Facility		$109.44	$115.54	$115.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $13.13 / $109.44 / $135.47	Professional		$13.13	$109.44	$135.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $62.99 / $135.47	Professional		$11.11	$62.99	$135.47
United Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $69.93 / $109.69	Professional		$47.94	$69.93	$109.69