Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.83 / $228.96 / $714.49	Facility		$115.83	$228.96	$714.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $116.99 / $238.09	Professional		$112.45	$116.99	$238.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.01 / $250.42 / $473.71	Facility		$139.01	$250.42	$473.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.80 / $137.68 / $137.68	Professional		$130.80	$137.68	$137.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $153.96 / $153.96 / $153.96	Facility		$153.96	$153.96	$153.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $183.87	Professional		$112.45	$112.45	$183.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $229.94 / $706.76	Facility		$112.45	$229.94	$706.76
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $117.92 / $238.09	Professional		$112.45	$117.92	$238.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $131.65 / $145.37	Professional		$129.31	$131.65	$145.37
United Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $119.30	Professional		$112.45	$112.45	$119.30