Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.34 / $352.44 / $387.45	Facility		$124.34	$352.44	$387.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.76 / $124.34 / $127.38	Professional		$107.76	$124.34	$127.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $329.55 / $656.59 / $1,195.85	Facility		$329.55	$656.59	$1,195.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.84 / $217.73 / $293.94	Professional		$206.84	$217.73	$293.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.32 / $125.32 / $141.52	Facility		$125.32	$125.32	$141.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $174.18 / $174.18 / $174.18	Professional		$174.18	$174.18	$174.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.33 / $138.33 / $203.46	Facility		$138.33	$138.33	$203.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $181.04 / $315.47	Professional		$100.98	$181.04	$315.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $157.34 / $352.44 / $387.45	Facility		$157.34	$352.44	$387.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $115.79 / $157.34 / $222.52	Professional		$115.79	$157.34	$222.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.11 / $161.12 / $185.28	Professional		$132.11	$161.12	$185.28
United Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $102.25 / $155.83	Professional		$75.31	$102.25	$155.83