Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.65 / $337.52 / $412.78	Facility		$89.65	$337.52	$412.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.45 / $89.65 / $89.65	Professional		$74.45	$89.65	$89.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $237.58 / $473.36 / $862.14	Facility		$237.58	$473.36	$862.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.12 / $156.97 / $211.91	Professional		$149.12	$156.97	$211.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.58 / $102.03 / $102.60	Facility		$99.58	$102.03	$102.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.58 / $125.58 / $125.58	Professional		$125.58	$125.58	$125.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.06 / $99.06 / $99.06	Facility		$99.06	$99.06	$99.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.06 / $99.06 / $181.88	Professional		$99.06	$99.06	$181.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $113.43 / $337.52 / $412.78	Facility		$113.43	$337.52	$412.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $84.31 / $113.43 / $164.81	Professional		$84.31	$113.43	$164.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.25 / $116.16 / $133.58	Professional		$95.25	$116.16	$133.58
United Facility/Professional Professional Modifier Low / Median / High Price $54.78 / $73.72 / $110.96	Professional		$54.78	$73.72	$110.96