Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.13 / $132.13 / $132.13	Facility		$132.13	$132.13	$132.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.39 / $132.13 / $144.24	Professional		$89.39	$132.13	$144.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $613.94 / $613.94 / $803.97	Facility		$613.94	$613.94	$803.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.24 / $17.39 / $226.00	Professional		$12.24	$17.39	$226.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.88 / $82.54 / $110.04	Facility		$10.88	$82.54	$110.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.39 / $100.44 / $159.34	Professional		$13.39	$100.44	$159.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.53 / $70.53 / $70.53	Facility		$70.53	$70.53	$70.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.53 / $70.53 / $189.38	Professional		$70.53	$70.53	$189.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $132.13 / $196.75	Professional		$16.73	$132.13	$196.75
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 $63.40 / $90.76 / $151.26	Professional		$63.40	$90.76	$151.26