Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.36 / $145.36 / $145.36	Facility		$145.36	$145.36	$145.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.24 / $145.36 / $145.36	Professional		$102.24	$145.36	$145.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $385.25 / $767.56 / $1,397.98	Facility		$385.25	$767.56	$1,397.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.80 / $254.53 / $343.62	Professional		$241.80	$254.53	$343.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $124.09 / $126.33 / $165.44	Facility		$124.09	$126.33	$165.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $203.62 / $203.62 / $203.62	Professional		$203.62	$203.62	$203.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.29 / $119.29 / $119.29	Facility		$119.29	$119.29	$119.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $211.64 / $368.91	Professional		$87.08	$211.64	$368.91
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $145.36 / $183.94 / $183.94	Facility		$145.36	$183.94	$183.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $136.71 / $183.94 / $267.25	Professional		$136.71	$183.94	$267.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $188.35 / $216.60	Professional		$154.44	$188.35	$216.60
United Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $114.77 / $182.18	Professional		$74.56	$114.77	$182.18