Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.32 / $159.32 / $159.32	Facility		$159.32	$159.32	$159.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $159.32 / $168.11	Professional		$144.13	$159.32	$168.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $422.24 / $841.26 / $1,532.21	Facility		$422.24	$841.26	$1,532.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.02 / $278.97 / $376.61	Professional		$265.02	$278.97	$376.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.33 / $181.33 / $181.33	Facility		$181.33	$181.33	$181.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.18 / $223.18 / $223.18	Professional		$223.18	$223.18	$223.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.32 / $174.32 / $174.32	Facility		$174.32	$174.32	$174.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.32 / $174.32 / $323.25	Professional		$174.32	$174.32	$323.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $159.32 / $201.59 / $201.59	Facility		$159.32	$201.59	$201.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $156.66 / $201.59 / $292.91	Professional		$156.66	$201.59	$292.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $169.28 / $206.44 / $237.40	Professional		$169.28	$206.44	$237.40
United Facility/Professional Professional Modifier Low / Median / High Price $108.97 / $133.37 / $199.66	Professional		$108.97	$133.37	$199.66