Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.03 / $105.03 / $105.03	Facility		$105.03	$105.03	$105.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.23 / $105.03 / $121.42	Professional		$93.23	$105.03	$121.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $278.36 / $554.60 / $1,010.11	Facility		$278.36	$554.60	$1,010.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.71 / $183.91 / $248.28	Professional		$174.71	$183.91	$248.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $119.54 / $144.74 / $159.30	Facility		$119.54	$144.74	$159.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $147.13 / $147.13	Professional		$147.13	$147.13	$147.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.23 / $126.23 / $126.23	Facility		$126.23	$126.23	$126.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.23 / $126.23 / $213.38	Professional		$126.23	$126.23	$213.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $105.03 / $132.90 / $132.90	Facility		$105.03	$132.90	$132.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $105.03 / $132.90 / $208.21	Professional		$105.03	$132.90	$208.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $111.59 / $136.09 / $156.50	Professional		$111.59	$136.09	$156.50
United Facility/Professional Professional Modifier Low / Median / High Price $71.80 / $87.92 / $131.63	Professional		$71.80	$87.92	$131.63