Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.02 / $147.02 / $147.02	Facility		$147.02	$147.02	$147.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.80 / $147.02 / $193.84	Professional		$119.80	$147.02	$193.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $339.57 / $676.55 / $1,232.22	Facility		$339.57	$676.55	$1,232.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.13 / $224.35 / $302.87	Professional		$213.13	$224.35	$302.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $145.83 / $145.83 / $159.18	Facility		$145.83	$145.83	$159.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $179.48 / $179.48 / $179.48	Professional		$179.48	$179.48	$179.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $214.95 / $214.95 / $214.95	Facility		$214.95	$214.95	$214.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.30 / $214.95 / $285.41	Professional		$209.30	$214.95	$285.41
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $147.02 / $248.05 / $248.05	Facility		$147.02	$248.05	$248.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $147.02 / $224.35 / $273.49	Professional		$147.02	$224.35	$273.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $178.44 / $217.61 / $250.25	Professional		$178.44	$217.61	$250.25
United Facility/Professional Professional Modifier Low / Median / High Price $134.82 / $161.78 / $245.68	Professional		$134.82	$161.78	$245.68