Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.23 / $173.23 / $173.23	Facility		$173.23	$173.23	$173.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $173.23 / $173.23	Professional		$150.13	$173.23	$173.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $459.11 / $914.72 / $1,666.01	Facility		$459.11	$914.72	$1,666.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.16 / $303.33 / $409.50	Professional		$288.16	$303.33	$409.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $197.16 / $200.67 / $209.03	Facility		$197.16	$200.67	$209.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $242.66 / $242.66 / $242.66	Professional		$242.66	$242.66	$242.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $196.21 / $196.21 / $196.21	Facility		$196.21	$196.21	$196.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.21 / $196.21 / $351.75	Professional		$196.21	$196.21	$351.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $173.23 / $219.20 / $219.20	Facility		$173.23	$219.20	$219.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $173.23 / $219.20 / $341.17	Professional		$173.23	$219.20	$341.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $145.03	Professional		$30.00	$30.00	$145.03
United Facility/Professional Professional Modifier Low / Median / High Price $126.11 / $145.01 / $217.09	Professional		$126.11	$145.01	$217.09