Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $106.00 / $106.00	Facility		$106.00	$106.00	$106.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.86 / $106.00 / $106.00	Professional		$91.86	$106.00	$106.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $280.92 / $559.70 / $1,019.39	Facility		$280.92	$559.70	$1,019.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.32 / $185.60 / $250.56	Professional		$176.32	$185.60	$250.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.64 / $134.02 / $138.00	Facility		$120.64	$134.02	$138.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $148.47 / $148.47 / $148.47	Professional		$148.47	$148.47	$148.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.06 / $120.06 / $120.06	Facility		$120.06	$120.06	$120.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.06 / $120.06 / $215.25	Professional		$120.06	$120.06	$215.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $134.11 / $134.11	Facility		$106.00	$134.11	$134.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $134.11 / $194.88	Professional		$106.00	$134.11	$194.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.61 / $137.34 / $157.94	Professional		$112.61	$137.34	$157.94
United Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $87.15 / $132.83	Professional		$66.25	$87.15	$132.83