Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.21 / $139.21 / $139.21	Facility		$139.21	$139.21	$139.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.65 / $139.21 / $139.21	Professional		$120.65	$139.21	$139.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $368.93 / $735.05 / $1,338.77	Facility		$368.93	$735.05	$1,338.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.56 / $243.75 / $329.06	Professional		$231.56	$243.75	$329.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $158.44 / $161.83	Facility		$133.72	$158.44	$161.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $195.00 / $195.00 / $195.00	Professional		$195.00	$195.00	$195.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.94 / $142.94 / $142.94	Facility		$142.94	$142.94	$142.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.94 / $142.94 / $282.75	Professional		$142.94	$142.94	$282.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $139.21 / $176.13 / $176.13	Facility		$139.21	$176.13	$176.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $130.91 / $176.13 / $255.93	Professional		$130.91	$176.13	$255.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $180.38 / $207.43	Professional		$147.91	$180.38	$207.43
United Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $110.78 / $162.85	Professional		$81.06	$110.78	$162.85