Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.01 / $91.01 / $91.01	Facility		$91.01	$91.01	$91.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $91.01 / $91.01	Professional		$75.59	$91.01	$91.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $241.22 / $480.60 / $875.32	Facility		$241.22	$480.60	$875.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.40 / $159.37 / $215.15	Professional		$151.40	$159.37	$215.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.11 / $103.59 / $104.15	Facility		$101.11	$103.59	$104.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.96 / $88.96 / $88.96	Facility		$88.96	$88.96	$88.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $88.96 / $184.88	Professional		$75.81	$88.96	$184.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $91.01 / $115.17 / $115.17	Facility		$91.01	$115.17	$115.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.95 / $115.17 / $167.33	Professional		$88.95	$115.17	$167.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.24 / $117.93 / $135.61	Professional		$100.24	$117.93	$135.61
United Facility/Professional Professional Modifier Low / Median / High Price $55.61 / $74.84 / $114.07	Professional		$55.61	$74.84	$114.07