Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.57 / $205.57 / $205.57	Facility		$205.57	$205.57	$205.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.83 / $197.77 / $205.57	Professional		$135.83	$197.77	$205.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $932.85 / $932.85 / $1,221.58	Facility		$932.85	$932.85	$1,221.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.59 / $26.42 / $343.40	Professional		$18.59	$26.42	$343.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.54 / $158.05 / $210.70	Facility		$16.54	$158.05	$210.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $152.62 / $259.32	Professional		$20.35	$152.62	$259.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.31 / $166.31 / $218.29	Facility		$166.31	$166.31	$218.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.31 / $173.33 / $218.29	Professional		$166.31	$173.33	$218.29
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $205.57 / $317.95	Professional		$102.95	$205.57	$317.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $107.46 / $173.33	Professional		$14.21	$107.46	$173.33
United Facility/Professional Professional Modifier Low / Median / High Price $106.39 / $159.74 / $226.10	Professional		$106.39	$159.74	$226.10