Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.02 / $208.02 / $208.02	Facility		$208.02	$208.02	$208.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.68 / $180.49 / $208.02	Professional		$133.68	$180.49	$208.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.07 / $918.07 / $1,202.23	Facility		$918.07	$918.07	$1,202.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.30 / $237.82 / $337.96	Professional		$18.30	$237.82	$337.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.36 / $162.72 / $226.88	Facility		$16.36	$162.72	$226.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.02 / $150.21 / $279.24	Professional		$20.02	$150.21	$279.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $160.96 / $215.49	Facility		$160.96	$160.96	$215.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $200.77 / $261.08	Professional		$160.96	$200.77	$261.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.22 / $208.02 / $327.91	Professional		$25.22	$208.02	$327.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.40 / $161.86 / $261.08	Professional		$21.40	$161.86	$261.08
United Facility/Professional Professional Modifier Low / Median / High Price $110.87 / $172.02 / $266.81	Professional		$110.87	$172.02	$266.81