Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.31 / $148.31 / $148.31	Facility		$148.31	$148.31	$148.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.19 / $148.31 / $148.31	Professional		$123.19	$148.31	$148.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $393.08 / $783.15 / $1,426.38	Facility		$393.08	$783.15	$1,426.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.71 / $259.70 / $350.60	Professional		$246.71	$259.70	$350.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.75 / $168.81 / $169.72	Facility		$164.75	$168.81	$169.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $207.76 / $207.76 / $207.76	Professional		$207.76	$207.76	$207.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.00 / $168.00 / $168.00	Facility		$168.00	$168.00	$168.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.64 / $173.53 / $334.25	Professional		$122.64	$173.53	$334.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $148.31 / $187.67 / $187.67	Facility		$148.31	$187.67	$187.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $148.31 / $187.67 / $292.10	Professional		$148.31	$187.67	$292.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $90.62 / $121.96 / $183.56	Professional		$90.62	$121.96	$183.56