Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.25 / $120.25 / $120.25	Facility		$120.25	$120.25	$120.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.39 / $120.25 / $123.53	Professional		$104.39	$120.25	$123.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $318.68 / $634.92 / $1,156.42	Facility		$318.68	$634.92	$1,156.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.02 / $210.55 / $284.24	Professional		$200.02	$210.55	$284.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.34 / $136.86 / $174.80	Facility		$131.34	$136.86	$174.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $168.44 / $168.44 / $168.44	Professional		$168.44	$168.44	$168.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $136.19 / $136.19	Facility		$136.19	$136.19	$136.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $136.19 / $244.13	Professional		$136.19	$136.19	$244.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $120.25 / $152.16 / $152.16	Facility		$120.25	$152.16	$152.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $152.16 / $242.13	Professional		$120.25	$152.16	$242.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $155.81 / $179.18	Professional		$127.76	$155.81	$179.18
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $78.79 / $100.63 / $150.69	Professional		$78.79	$100.63	$150.69