Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.03 / $172.03 / $172.03	Facility		$172.03	$172.03	$172.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.46 / $172.03 / $195.21	Professional		$158.46	$172.03	$195.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $455.91 / $908.36 / $1,654.42	Facility		$455.91	$908.36	$1,654.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.16 / $301.22 / $406.65	Professional		$286.16	$301.22	$406.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $195.79 / $195.79 / $221.65	Facility		$195.79	$195.79	$221.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $240.98 / $240.98 / $240.98	Professional		$240.98	$240.98	$240.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.22 / $188.22 / $188.22	Facility		$188.22	$188.22	$188.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.22 / $188.22 / $349.13	Professional		$188.22	$188.22	$349.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $172.03 / $217.68 / $217.68	Facility		$172.03	$217.68	$217.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $172.03 / $217.68 / $316.27	Professional		$172.03	$217.68	$316.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $182.77 / $222.90 / $256.33	Professional		$182.77	$222.90	$256.33
United Facility/Professional Facility Modifier Low / Median / High Price $204.62 / $204.62 / $204.62	Facility		$204.62	$204.62	$204.62
United Facility/Professional Professional Modifier Low / Median / High Price $117.66 / $144.01 / $215.59	Professional		$117.66	$144.01	$215.59