Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $190.00 / $190.00	Facility		$190.00	$190.00	$190.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $190.00 / $199.50	Professional		$134.47	$190.00	$199.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $720.59 / $960.76 / $1,258.13	Facility		$720.59	$960.76	$1,258.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $196.49 / $353.67	Professional		$19.14	$196.49	$353.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.83 / $16.28 / $131.63	Facility		$13.83	$16.28	$131.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.03 / $20.03 / $293.39	Professional		$20.03	$20.03	$293.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.77 / $153.77 / $153.77	Facility		$153.77	$153.77	$153.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.44 / $153.77 / $288.75	Professional		$18.44	$153.77	$288.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $135.18 / $249.50	Professional		$24.95	$135.18	$249.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.93 / $17.35 / $157.83	Professional		$12.93	$17.35	$157.83
United Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $105.46 / $163.09	Professional		$77.84	$105.46	$163.09