Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.77 / $111.77 / $111.77	Facility		$111.77	$111.77	$111.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $109.45 / $111.77	Professional		$77.09	$109.45	$111.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $397.13 / $529.52 / $693.42	Facility		$397.13	$529.52	$693.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $108.29 / $194.93	Professional		$11.11	$108.29	$194.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.39 / $77.08 / $102.80	Facility		$9.39	$77.08	$102.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.55 / $86.63 / $126.52	Professional		$11.55	$86.63	$126.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.16 / $88.16 / $88.16	Facility		$88.16	$88.16	$88.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.16 / $102.18 / $117.65	Professional		$88.16	$102.18	$117.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $57.34 / $111.77 / $158.15	Professional		$57.34	$111.77	$158.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.52 / $12.77 / $115.98	Professional		$9.52	$12.77	$115.98
United Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $77.93 / $131.31	Professional		$52.69	$77.93	$131.31