Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.11 / $377.69 / $461.92	Facility		$108.11	$377.69	$461.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.38 / $108.11 / $113.51	Professional		$87.38	$108.11	$113.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $286.52 / $570.88 / $1,039.77	Facility		$286.52	$570.88	$1,039.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.84 / $189.31 / $255.57	Professional		$179.84	$189.31	$255.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.87 / $117.94 / $123.05	Facility		$105.87	$117.94	$123.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $151.44 / $151.44	Professional		$151.44	$151.44	$151.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.36 / $117.36 / $126.78	Facility		$117.36	$117.36	$126.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $219.38	Professional		$117.36	$117.36	$219.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $136.82 / $377.69 / $461.92	Facility		$136.82	$377.69	$461.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $93.74 / $136.82 / $198.77	Professional		$93.74	$136.82	$198.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $114.87 / $140.09 / $161.10	Professional		$114.87	$140.09	$161.10
United Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $87.33 / $125.94	Professional		$62.76	$87.33	$125.94