Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.40 / $164.40 / $164.40	Facility		$164.40	$164.40	$164.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.49 / $151.41 / $164.40	Professional		$111.49	$151.41	$164.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $765.70 / $765.70 / $1,002.69	Facility		$765.70	$765.70	$1,002.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.05 / $198.35 / $281.87	Professional		$16.05	$198.35	$281.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.57 / $118.60 / $158.15	Facility		$13.57	$118.60	$158.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.70 / $125.27 / $194.65	Professional		$16.70	$125.27	$194.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.68 / $130.68 / $171.51	Facility		$130.68	$130.68	$171.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.20 / $130.68 / $171.51	Professional		$98.20	$130.68	$171.51
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $104.08 / $164.40 / $243.31	Professional		$104.08	$164.40	$243.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.50 / $30.00 / $140.28	Professional		$11.50	$30.00	$140.28
United Facility/Professional Professional Modifier Low / Median / High Price $71.54 / $114.26 / $179.67	Professional		$71.54	$114.26	$179.67