Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.61 / $160.61 / $160.61	Facility		$160.61	$160.61	$160.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.20 / $160.61 / $175.34	Professional		$107.20	$160.61	$175.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $751.61 / $751.61 / $984.25	Facility		$751.61	$751.61	$984.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $153.71 / $276.68	Professional		$14.98	$153.71	$276.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.98 / $98.46 / $131.29	Facility		$12.98	$98.46	$131.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.39 / $122.97 / $187.85	Professional		$16.39	$122.97	$187.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.15 / $83.15 / $83.15	Facility		$83.15	$83.15	$83.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.15 / $83.15 / $228.75	Professional		$83.15	$83.15	$228.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $16.97 / $160.61 / $234.81	Professional		$16.97	$160.61	$234.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $108.31 / $157.93	Professional		$76.59	$108.31	$157.93