Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.43 / $70.43 / $70.43	Facility		$70.43	$70.43	$70.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.56 / $70.43 / $79.92	Professional		$64.56	$70.43	$79.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.65 / $371.88 / $677.32	Facility		$186.65	$371.88	$677.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.15 / $123.32 / $166.48	Professional		$117.15	$123.32	$166.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.16 / $80.16 / $82.13	Facility		$80.16	$80.16	$82.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $98.66 / $98.66 / $98.66	Professional		$98.66	$98.66	$98.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.77 / $79.77 / $79.77	Facility		$79.77	$79.77	$79.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.77 / $79.77 / $142.88	Professional		$79.77	$79.77	$142.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.43 / $89.12 / $89.12	Facility		$70.43	$89.12	$89.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.25 / $89.12 / $129.47	Professional		$69.25	$89.12	$129.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.83 / $91.26 / $104.94	Professional		$74.83	$91.26	$104.94
United Facility/Professional Professional Modifier Low / Median / High Price $48.17 / $60.98 / $88.26	Professional		$48.17	$60.98	$88.26