Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.54 / $107.54 / $107.54	Facility		$107.54	$107.54	$107.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.20 / $107.54 / $114.34	Professional		$93.20	$107.54	$114.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $285.02 / $567.87 / $1,034.27	Facility		$285.02	$567.87	$1,034.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.89 / $188.31 / $254.22	Professional		$178.89	$188.31	$254.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.69 / $122.40 / $130.51	Facility		$114.69	$122.40	$130.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $150.65 / $150.65 / $150.65	Professional		$150.65	$150.65	$150.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $121.82 / $121.82	Facility		$121.82	$121.82	$121.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.82 / $121.82 / $218.25	Professional		$121.82	$121.82	$218.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $107.54 / $136.08 / $136.08	Facility		$107.54	$136.08	$136.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.54 / $136.08 / $211.80	Professional		$107.54	$136.08	$211.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $71.41	Professional		$30.00	$30.00	$71.41
United Facility/Professional Professional Modifier Low / Median / High Price $68.92 / $88.43 / $134.78	Professional		$68.92	$88.43	$134.78