Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.21 / $95.21 / $95.21	Facility		$95.21	$95.21	$95.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.12 / $95.21 / $95.21	Professional		$71.12	$95.21	$95.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.36 / $502.79 / $915.75	Facility		$252.36	$502.79	$915.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.38 / $166.73 / $225.09	Professional		$158.38	$166.73	$225.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.88 / $104.78 / $108.37	Facility		$87.88	$104.78	$108.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $133.38 / $133.38 / $133.38	Professional		$133.38	$133.38	$133.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.36 / $112.36 / $112.36	Facility		$112.36	$112.36	$112.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.36 / $112.36 / $193.13	Professional		$112.36	$112.36	$193.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $95.21 / $120.48 / $120.48	Facility		$95.21	$120.48	$120.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $93.71 / $120.48 / $175.06	Professional		$93.71	$120.48	$175.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $101.17 / $123.38 / $141.88	Professional		$101.17	$123.38	$141.88
United Facility/Professional Professional Modifier Low / Median / High Price $52.81 / $76.90 / $111.40	Professional		$52.81	$76.90	$111.40