Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.18 / $146.18 / $146.18	Facility		$146.18	$146.18	$146.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.75 / $139.68 / $146.18	Professional		$97.75	$139.68	$146.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $671.34 / $671.34 / $879.13	Facility		$671.34	$671.34	$879.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.08 / $130.44 / $247.13	Professional		$14.08	$130.44	$247.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.90 / $109.20 / $162.44	Facility		$11.90	$109.20	$162.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.65 / $109.84 / $179.19	Professional		$14.65	$109.84	$179.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $114.47 / $150.25	Facility		$114.47	$114.47	$150.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.47 / $137.96 / $162.96	Professional		$114.47	$137.96	$162.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $90.71 / $146.66 / $223.99	Professional		$90.71	$146.66	$223.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.35 / $75.77 / $162.96	Professional		$13.35	$75.77	$162.96
United Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $116.36 / $186.00	Professional		$72.56	$116.36	$186.00