Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.21 / $119.21 / $119.21	Facility		$119.21	$119.21	$119.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.70 / $119.21 / $119.21	Professional		$100.70	$119.21	$119.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $315.94 / $629.48 / $1,146.48	Facility		$315.94	$629.48	$1,146.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.30 / $208.74 / $281.80	Professional		$198.30	$208.74	$281.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $133.75 / $135.68 / $136.41	Facility		$133.75	$135.68	$136.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $166.99 / $166.99 / $166.99	Professional		$166.99	$166.99	$166.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.05 / $147.05 / $147.05	Facility		$147.05	$147.05	$147.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.35 / $173.56 / $302.33	Professional		$107.35	$173.56	$302.33
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $119.21 / $150.83 / $150.83	Facility		$119.21	$150.83	$150.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $116.63 / $150.83 / $219.17	Professional		$116.63	$150.83	$219.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.29 / $154.47 / $177.64	Professional		$131.29	$154.47	$177.64
United Facility/Professional Professional Modifier Low / Median / High Price $78.01 / $98.02 / $148.46	Professional		$78.01	$98.02	$148.46