Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.29 / $123.29 / $123.29	Facility		$123.29	$123.29	$123.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.48 / $123.29 / $135.90	Professional		$108.48	$123.29	$135.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $326.75 / $651.01 / $1,185.70	Facility		$326.75	$651.01	$1,185.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.09 / $215.88 / $291.44	Professional		$205.09	$215.88	$291.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $136.47 / $136.47 / $140.32	Facility		$136.47	$136.47	$140.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $172.70 / $172.70	Professional		$172.70	$172.70	$172.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $139.66 / $139.66	Facility		$139.66	$139.66	$139.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $139.66 / $250.13	Professional		$139.66	$139.66	$250.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $123.29 / $156.01 / $156.01	Facility		$123.29	$156.01	$156.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $123.29 / $156.01 / $226.67	Professional		$123.29	$156.01	$226.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.99 / $159.75 / $183.71	Professional		$130.99	$159.75	$183.71
United Facility/Professional Professional Modifier Low / Median / High Price $82.02 / $103.21 / $154.51	Professional		$82.02	$103.21	$154.51