Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.94 / $137.94 / $137.94	Facility		$137.94	$137.94	$137.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.65 / $126.92 / $137.94	Professional		$91.65	$126.92	$137.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $629.41 / $629.41 / $824.24	Facility		$629.41	$629.41	$824.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.20 / $163.05 / $231.70	Professional		$13.20	$163.05	$231.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.15 / $104.66 / $134.71	Facility		$11.15	$104.66	$134.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.73 / $102.98 / $171.77	Professional		$13.73	$102.98	$171.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.90 / $115.90 / $144.38	Facility		$115.90	$115.90	$144.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.90 / $118.76 / $144.38	Professional		$115.90	$118.76	$144.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $17.16 / $137.93 / $214.71	Professional		$17.16	$137.93	$214.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $118.76 / $130.63	Professional		$95.00	$118.76	$130.63
United Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $96.82 / $161.36	Professional		$69.50	$96.82	$161.36