Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.94 / $156.94 / $156.94	Facility		$156.94	$156.94	$156.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.89 / $156.94 / $198.23	Professional		$118.89	$156.94	$198.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $336.99 / $671.42 / $1,222.88	Facility		$336.99	$671.42	$1,222.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.52 / $222.65 / $300.58	Professional		$211.52	$222.65	$300.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $144.72 / $144.72 / $170.48	Facility		$144.72	$144.72	$170.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $178.12 / $178.12 / $178.12	Professional		$178.12	$178.12	$178.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $278.10 / $278.10 / $278.10	Facility		$278.10	$278.10	$278.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.10 / $278.10 / $347.45	Professional		$278.10	$278.10	$347.45
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $156.94 / $285.81 / $285.81	Facility		$156.94	$285.81	$285.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $156.94 / $242.93 / $314.39	Professional		$156.94	$242.93	$314.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.90 / $251.65 / $289.39	Professional		$213.90	$251.65	$289.39
United Facility/Professional Professional Modifier Low / Median / High Price $138.97 / $196.24 / $315.54	Professional		$138.97	$196.24	$315.54