Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.66 / $130.66 / $130.66	Facility		$130.66	$130.66	$130.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $130.66 / $130.66	Professional		$105.91	$130.66	$130.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.32 / $690.00 / $1,256.72	Facility		$346.32	$690.00	$1,256.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.37 / $228.81 / $308.89	Professional		$217.37	$228.81	$308.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $118.49 / $138.37 / $148.72	Facility		$118.49	$138.37	$148.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $183.05 / $183.05 / $183.05	Professional		$183.05	$183.05	$183.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $111.95 / $111.95	Facility		$111.95	$111.95	$111.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.94 / $111.95 / $265.13	Professional		$111.94	$111.95	$265.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $130.66 / $165.35 / $165.35	Facility		$130.66	$165.35	$165.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $130.66 / $165.35 / $257.00	Professional		$130.66	$165.35	$257.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $85.66	Professional		$30.00	$30.00	$85.66
United Facility/Professional Professional Modifier Low / Median / High Price $69.98 / $105.54 / $152.88	Professional		$69.98	$105.54	$152.88