Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.69 / $141.69 / $141.69	Facility		$141.69	$141.69	$141.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.01 / $127.82 / $141.69	Professional		$93.01	$127.82	$141.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $638.73 / $638.73 / $836.43	Facility		$638.73	$638.73	$836.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.40 / $130.63 / $235.13	Professional		$13.40	$130.63	$235.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.41 / $110.62 / $147.49	Facility		$11.41	$110.62	$147.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.94 / $104.50 / $181.53	Professional		$13.94	$104.50	$181.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.51 / $115.51 / $151.61	Facility		$115.51	$115.51	$151.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.51 / $121.32 / $151.61	Professional		$115.51	$121.32	$151.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $141.69 / $226.91	Professional		$72.06	$141.69	$226.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.94 / $75.21 / $121.32	Professional		$9.94	$75.21	$121.32
United Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $108.47 / $158.26	Professional		$72.06	$108.47	$158.26