Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.48 / $97.62 / $16,305.90	Facility		$77.48	$97.62	$16,305.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $75.97 / $91.88	Professional		$75.22	$75.97	$91.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.37 / $164.04 / $312.57	Facility		$87.37	$164.04	$312.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.45 / $78.23 / $101.55	Professional		$71.45	$78.23	$101.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.22 / $82.74 / $113.90	Facility		$75.22	$82.74	$113.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $78.98 / $174.40	Professional		$75.22	$78.98	$174.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $75.22 / $98.24	Professional		$75.22	$75.22	$98.24
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $75.22 / $112.74 / $16,305.90	Facility		$75.22	$112.74	$16,305.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $77.48 / $97.76	Professional		$75.22	$77.48	$97.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $83.52 / $112.83	Professional		$75.22	$83.52	$112.83
United Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $83.74 / $93.29	Professional		$75.22	$83.74	$93.29