Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.77 / $129.77 / $129.77	Facility		$129.77	$129.77	$129.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.32 / $129.77 / $163.90	Professional		$98.32	$129.77	$163.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $278.70 / $555.29 / $1,011.37	Facility		$278.70	$555.29	$1,011.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.93 / $184.14 / $248.59	Professional		$174.93	$184.14	$248.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $119.69 / $119.69 / $140.99	Facility		$119.69	$119.69	$140.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.31 / $147.31 / $147.31	Professional		$147.31	$147.31	$147.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.82 / $211.82 / $211.82	Facility		$211.82	$211.82	$211.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.82 / $211.82 / $287.27	Professional		$211.82	$211.82	$287.27
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $129.77 / $236.32 / $236.32	Facility		$129.77	$236.32	$236.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $129.77 / $200.87 / $259.95	Professional		$129.77	$200.87	$259.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $176.88 / $208.10 / $239.31	Professional		$176.88	$208.10	$239.31
United Facility/Professional Professional Modifier Low / Median / High Price $108.73 / $162.25 / $270.42	Professional		$108.73	$162.25	$270.42