Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.41 / $161.41 / $161.41	Facility		$161.41	$161.41	$161.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.90 / $148.55 / $161.41	Professional		$103.90	$148.55	$161.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $713.51 / $713.51 / $934.35	Facility		$713.51	$713.51	$934.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.22 / $138.62 / $262.66	Professional		$14.22	$138.62	$262.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.90 / $126.46 / $196.42	Facility		$12.90	$126.46	$196.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.57 / $116.74 / $215.87	Professional		$15.57	$116.74	$215.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.59 / $123.59 / $123.59	Facility		$123.59	$123.59	$123.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.59 / $127.30 / $222.38	Professional		$123.59	$127.30	$222.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.84 / $161.41 / $263.83	Professional		$100.84	$161.41	$263.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.16 / $69.02 / $148.44	Professional		$12.16	$69.02	$148.44
United Facility/Professional Professional Modifier Low / Median / High Price $79.66 / $129.01 / $188.22	Professional		$79.66	$129.01	$188.22