Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.90 / $158.65 / $195.16	Facility		$64.90	$158.65	$195.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $64.90 / $64.90	Professional		$46.22	$64.90	$64.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.00 / $342.69 / $624.16	Facility		$172.00	$342.69	$624.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.96 / $113.64 / $153.41	Professional		$107.96	$113.64	$153.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.77 / $72.50 / $73.87	Facility		$64.77	$72.50	$73.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.91 / $90.91 / $90.91	Professional		$90.91	$90.91	$90.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.02 / $71.02 / $71.02	Facility		$71.02	$71.02	$71.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.02 / $71.02 / $131.63	Professional		$71.02	$71.02	$131.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $82.12 / $158.65 / $195.16	Facility		$82.12	$158.65	$195.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $57.87 / $82.12 / $119.32	Professional		$57.87	$82.12	$119.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.95 / $84.09 / $96.70	Professional		$68.95	$84.09	$96.70
United Facility/Professional Professional Modifier Low / Median / High Price $35.43 / $52.42 / $81.33	Professional		$35.43	$52.42	$81.33