Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.09 / $120.09 / $120.09	Facility		$120.09	$120.09	$120.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.36 / $120.09 / $120.09	Professional		$71.36	$120.09	$120.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.43 / $340.42 / $715.78	Facility		$169.43	$340.42	$715.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $126.96 / $180.41	Professional		$9.77	$126.96	$180.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $68.95 / $126.13	Facility		$8.69	$68.95	$126.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.70 / $80.18 / $106.91	Professional		$10.70	$80.18	$106.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $96.60 / $96.60	Facility		$96.60	$96.60	$96.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.41 / $96.60 / $134.63	Professional		$94.41	$96.60	$134.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $120.09 / $168.95	Facility		$16.89	$120.09	$168.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $120.09 / $168.95	Professional		$16.32	$120.09	$168.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.44 / $30.00 / $134.63	Professional		$11.44	$30.00	$134.63
United Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $105.42 / $176.87	Professional		$67.14	$105.42	$176.87