Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.63 / $166.63 / $166.63	Facility		$166.63	$166.63	$166.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.91 / $166.63 / $174.37	Professional		$99.91	$166.63	$174.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $601.91 / $802.55 / $1,050.96	Facility		$601.91	$802.55	$1,050.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.99 / $207.90 / $295.43	Professional		$15.99	$207.90	$295.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.47 / $105.61 / $135.02	Facility		$13.47	$105.61	$135.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.34 / $131.31 / $175.07	Professional		$17.34	$131.31	$175.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.41 / $134.41 / $134.41	Facility		$134.41	$134.41	$134.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.41 / $137.22 / $181.96	Professional		$134.41	$137.22	$181.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $158.15 / $218.84	Professional		$19.50	$158.15	$218.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.25 / $85.07 / $137.22	Professional		$11.25	$85.07	$137.22
United Facility/Professional Professional Modifier Low / Median / High Price $72.66 / $100.94 / $145.63	Professional		$72.66	$100.94	$145.63