Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.80 / $88.80 / $88.80	Facility		$88.80	$88.80	$88.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.41 / $88.80 / $88.80	Professional		$67.41	$88.80	$88.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.34 / $468.90 / $854.01	Facility		$235.34	$468.90	$854.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.72 / $155.49 / $209.91	Professional		$147.72	$155.49	$209.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.16 / $90.16 / $101.07	Facility		$90.16	$90.16	$101.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $124.39 / $124.39 / $124.39	Professional		$124.39	$124.39	$124.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.66 / $86.66 / $86.66	Facility		$86.66	$86.66	$86.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.66 / $86.66 / $180.38	Professional		$86.66	$86.66	$180.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $88.80 / $112.36 / $112.36	Facility		$88.80	$112.36	$112.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.97 / $112.36 / $163.26	Professional		$87.97	$112.36	$163.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $115.06 / $132.31	Professional		$94.34	$115.06	$132.31
United Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $73.01 / $109.89	Professional		$54.18	$73.01	$109.89