Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.22 / $91.22 / $91.22	Facility		$91.22	$91.22	$91.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.81 / $91.22 / $91.22	Professional		$69.81	$91.22	$91.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $241.76 / $481.68 / $877.30	Facility		$241.76	$481.68	$877.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.74 / $159.72 / $215.64	Professional		$151.74	$159.72	$215.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.76 / $87.83 / $103.82	Facility		$85.76	$87.83	$103.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $127.78 / $127.78 / $127.78	Professional		$127.78	$127.78	$127.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.32 / $103.32 / $103.32	Facility		$103.32	$103.32	$103.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.32 / $103.32 / $185.25	Professional		$103.32	$103.32	$185.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $91.22 / $115.43 / $115.43	Facility		$91.22	$115.43	$115.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $115.43 / $167.71	Professional		$83.18	$115.43	$167.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.92 / $118.20 / $135.93	Professional		$96.92	$118.20	$135.93
United Facility/Professional Professional Modifier Low / Median / High Price $51.54 / $73.68 / $109.70	Professional		$51.54	$73.68	$109.70