Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.59 / $83.59 / $831.16	Facility		$83.59	$83.59	$831.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.42 / $83.59 / $83.59	Professional		$69.42	$83.59	$83.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.54 / $441.39 / $803.92	Facility		$221.54	$441.39	$803.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.05 / $146.37 / $197.60	Professional		$139.05	$146.37	$197.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.84 / $95.14 / $95.65	Facility		$92.84	$95.14	$95.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.10 / $117.10 / $117.10	Professional		$117.10	$117.10	$117.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $81.70 / $81.70	Facility		$81.70	$81.70	$81.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.70 / $81.70 / $169.50	Professional		$81.70	$81.70	$169.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $83.59 / $105.79 / $831.16	Facility		$83.59	$105.79	$831.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $78.62 / $105.79 / $153.68	Professional		$78.62	$105.79	$153.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.81 / $108.31 / $124.55	Professional		$88.81	$108.31	$124.55
United Facility/Professional Professional Modifier Low / Median / High Price $51.07 / $68.73 / $103.45	Professional		$51.07	$68.73	$103.45