Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.67 / $100.67 / $100.67	Facility		$100.67	$100.67	$100.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.07 / $100.67 / $114.23	Professional		$91.07	$100.67	$114.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $266.79 / $531.55 / $968.15	Facility		$266.79	$531.55	$968.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.46 / $176.27 / $237.96	Professional		$167.46	$176.27	$237.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.58 / $114.58 / $122.38	Facility		$114.58	$114.58	$122.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.02 / $141.02 / $141.02	Professional		$141.02	$141.02	$141.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.15 / $110.15 / $110.15	Facility		$110.15	$110.15	$110.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.14 / $110.15 / $204.38	Professional		$110.14	$110.15	$204.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $100.67 / $127.38 / $127.38	Facility		$100.67	$127.38	$127.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.67 / $127.38 / $185.08	Professional		$100.67	$127.38	$185.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.96 / $130.44 / $150.00	Professional		$106.96	$130.44	$150.00
United Facility/Professional Professional Modifier Low / Median / High Price $73.28 / $84.27 / $126.16	Professional		$73.28	$84.27	$126.16