Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.28 / $207.28 / $207.28	Facility		$207.28	$207.28	$207.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.71 / $207.28 / $209.30	Professional		$144.71	$207.28	$209.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.42 / $213.41 / $384.14	Professional		$38.42	$213.41	$384.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.43 / $18.45 / $177.81	Facility		$16.43	$18.45	$177.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.68 / $22.70 / $310.56	Professional		$21.68	$22.70	$310.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.27 / $174.27 / $174.27	Facility		$174.27	$174.27	$174.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.86 / $174.27 / $307.50	Professional		$19.86	$174.27	$307.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $20.48 / $204.82 / $271.00	Professional		$20.48	$204.82	$271.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $81.47 / $121.27 / $202.85	Professional		$81.47	$121.27	$202.85