Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.80 / $106.80 / $106.80	Facility		$106.80	$106.80	$106.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.46 / $106.80 / $106.80	Professional		$85.46	$106.80	$106.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $283.05 / $563.95 / $1,027.13	Facility		$283.05	$563.95	$1,027.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.66 / $187.01 / $252.46	Professional		$177.66	$187.01	$252.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.18 / $121.56 / $131.31	Facility		$109.18	$121.56	$131.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $149.61 / $149.61 / $149.61	Professional		$149.61	$149.61	$149.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.63 / $132.63 / $132.63	Facility		$132.63	$132.63	$132.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.63 / $132.63 / $216.75	Professional		$132.63	$132.63	$216.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $106.80 / $135.13 / $135.13	Facility		$106.80	$135.13	$135.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.45 / $135.13 / $196.36	Professional		$100.45	$135.13	$196.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $113.47 / $138.38 / $159.14	Professional		$113.47	$138.38	$159.14
United Facility/Professional Professional Modifier Low / Median / High Price $59.18 / $87.81 / $124.94	Professional		$59.18	$87.81	$124.94