Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.02 / $165.02 / $165.02	Facility		$165.02	$165.02	$165.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.25 / $165.02 / $165.02	Professional		$139.25	$165.02	$165.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $437.34 / $871.36 / $1,587.03	Facility		$437.34	$871.36	$1,587.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $274.50 / $288.95 / $390.08	Professional		$274.50	$288.95	$390.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $172.06 / $172.06 / $187.82	Facility		$172.06	$172.06	$187.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $231.16 / $231.16 / $231.16	Professional		$231.16	$231.16	$231.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.40 / $165.40 / $165.40	Facility		$165.40	$165.40	$165.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.40 / $165.40 / $334.88	Professional		$165.40	$165.40	$334.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $165.02 / $208.82 / $208.82	Facility		$165.02	$208.82	$208.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $208.82 / $303.39	Professional		$163.38	$208.82	$303.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $175.33 / $213.82 / $245.89	Professional		$175.33	$213.82	$245.89
United Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $138.13 / $206.82	Professional		$103.40	$138.13	$206.82