Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.86 / $163.86 / $163.86	Facility		$163.86	$163.86	$163.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.29 / $163.86 / $163.86	Professional		$131.29	$163.86	$163.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $434.27 / $865.24 / $1,575.88	Facility		$434.27	$865.24	$1,575.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $272.57 / $286.92 / $387.34	Professional		$272.57	$286.92	$387.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.22 / $183.05 / $186.50	Facility		$162.22	$183.05	$186.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $229.54 / $229.54 / $229.54	Professional		$229.54	$229.54	$229.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.61 / $185.61 / $185.61	Facility		$185.61	$185.61	$185.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.61 / $185.61 / $332.63	Professional		$185.61	$185.61	$332.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $163.86 / $207.35 / $207.35	Facility		$163.86	$207.35	$207.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $150.21 / $207.35 / $301.26	Professional		$150.21	$207.35	$301.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $174.10 / $212.32 / $244.16	Professional		$174.10	$212.32	$244.16
United Facility/Professional Facility Modifier Low / Median / High Price $195.26 / $195.26 / $195.26	Facility		$195.26	$195.26	$195.26
United Facility/Professional Professional Modifier Low / Median / High Price $97.50 / $134.74 / $197.48	Professional		$97.50	$134.74	$197.48