Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.70 / $79.70 / $79.70	Facility		$79.70	$79.70	$79.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $79.70 / $79.70	Professional		$70.20	$79.70	$79.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $211.23 / $420.86 / $766.52	Facility		$211.23	$420.86	$766.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.58 / $139.56 / $188.41	Professional		$132.58	$139.56	$188.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.71 / $99.50 / $120.95	Facility		$90.71	$99.50	$120.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.65 / $111.65 / $111.65	Professional		$111.65	$111.65	$111.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.28 / $90.28 / $90.28	Facility		$90.28	$90.28	$90.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.28 / $90.28 / $161.63	Professional		$90.28	$90.28	$161.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.70 / $100.85 / $100.85	Facility		$79.70	$100.85	$100.85
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $79.08 / $100.85 / $160.49	Professional		$79.08	$100.85	$160.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $84.68 / $103.27 / $118.76	Professional		$84.68	$103.27	$118.76
United Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $69.47 / $116.04	Professional		$54.52	$69.47	$116.04