Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.72 / $158.72 / $158.72	Facility		$158.72	$158.72	$158.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.84 / $140.10 / $158.72	Professional		$103.84	$140.10	$158.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.84 / $735.20 / $980.27	Facility		$74.84	$735.20	$980.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $153.09 / $275.56	Professional		$19.39	$153.09	$275.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.64 / $16.64 / $160.55	Facility		$12.64	$16.64	$160.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.55 / $20.48 / $217.80	Professional		$15.55	$20.48	$217.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.00 / $112.73 / $112.73	Facility		$112.00	$112.73	$112.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $112.73 / $203.29	Professional		$16.55	$112.73	$203.29
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.44 / $158.72 / $194.40	Professional		$19.44	$158.72	$194.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $74.61 / $160.47	Professional		$13.15	$74.61	$160.47
United Facility/Professional Professional Modifier Low / Median / High Price $59.63 / $91.25 / $153.86	Professional		$59.63	$91.25	$153.86