Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.65 / $123.65 / $125.22	Facility		$123.65	$123.65	$125.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.09 / $117.39 / $125.22	Professional		$86.09	$117.39	$125.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $587.79 / $587.79 / $769.73	Facility		$587.79	$587.79	$769.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.27 / $160.28 / $216.38	Professional		$152.27	$160.28	$216.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.42 / $78.13 / $2,141.10	Facility		$10.42	$78.13	$2,141.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.45 / $98.45 / $98.45	Facility		$98.45	$98.45	$98.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.45 / $98.45 / $186.00	Professional		$98.45	$98.45	$186.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $16.03 / $101.74 / $160.28	Professional		$16.03	$101.74	$160.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Facility Modifier Low / Median / High Price $10.64 / $79.81 / $126.39	Facility		$10.64	$79.81	$126.39
United Facility/Professional Professional Modifier Low / Median / High Price $59.87 / $93.91 / $133.04	Professional		$59.87	$93.91	$133.04