Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.53 / $120.53 / $120.53	Facility		$120.53	$120.53	$120.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $120.53 / $120.53	Professional		$97.04	$120.53	$120.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $319.44 / $636.44 / $1,159.17	Facility		$319.44	$636.44	$1,159.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.50 / $211.05 / $284.92	Professional		$200.50	$211.05	$284.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $130.97 / $137.18 / $143.69	Facility		$130.97	$137.18	$143.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $168.84 / $168.84 / $168.84	Professional		$168.84	$168.84	$168.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.01 / $144.01 / $144.01	Facility		$144.01	$144.01	$144.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $144.01 / $244.50	Professional		$144.00	$144.01	$244.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $120.53 / $152.50 / $152.50	Facility		$120.53	$152.50	$152.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $120.53 / $152.50 / $237.37	Professional		$120.53	$152.50	$237.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $82.91	Professional		$30.00	$30.00	$82.91
United Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $99.10 / $151.04	Professional		$67.73	$99.10	$151.04