Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.69 / $169.69 / $253.42	Facility		$169.69	$169.69	$253.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.93 / $167.69 / $169.69	Professional		$151.93	$167.69	$169.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $449.73 / $896.03 / $1,631.96	Facility		$449.73	$896.03	$1,631.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.27 / $297.13 / $401.13	Professional		$282.27	$297.13	$401.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $179.19 / $191.15 / $193.13	Facility		$179.19	$191.15	$193.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $237.70 / $237.70 / $237.70	Professional		$237.70	$237.70	$237.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.78 / $190.78 / $190.78	Facility		$190.78	$190.78	$190.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.78 / $190.78 / $344.63	Professional		$190.78	$190.78	$344.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $169.69 / $214.71 / $253.42	Facility		$169.69	$214.71	$253.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $156.65 / $214.71 / $311.98	Professional		$156.65	$214.71	$311.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $180.30 / $219.88 / $252.86	Professional		$180.30	$219.88	$252.86
United Facility/Professional Professional Modifier Low / Median / High Price $101.89 / $139.53 / $211.70	Professional		$101.89	$139.53	$211.70