Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.90 / $89.90 / $217.62	Facility		$89.90	$89.90	$217.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.65 / $89.90 / $89.90	Professional		$74.65	$89.90	$89.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $238.28 / $474.75 / $864.67	Facility		$238.28	$474.75	$864.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.56 / $157.43 / $212.53	Professional		$149.56	$157.43	$212.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.86 / $102.33 / $102.91	Facility		$99.86	$102.33	$102.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.94 / $125.94 / $125.94	Professional		$125.94	$125.94	$125.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.85 / $88.85 / $88.85	Facility		$88.85	$88.85	$88.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $88.85 / $182.63	Professional		$88.85	$88.85	$182.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $89.90 / $113.76 / $217.62	Facility		$89.90	$113.76	$217.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $86.49 / $113.76 / $165.30	Professional		$86.49	$113.76	$165.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.81 / $30.00 / $30.00	Professional		$6.81	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.94 / $73.93 / $111.27	Professional		$54.94	$73.93	$111.27