Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.13 / $111.13 / $111.13	Facility		$111.13	$111.13	$111.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.31 / $111.13 / $111.13	Professional		$92.31	$111.13	$111.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.52 / $586.80 / $1,068.77	Facility		$294.52	$586.80	$1,068.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.86 / $194.59 / $262.70	Professional		$184.86	$194.59	$262.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.45 / $126.48 / $127.17	Facility		$123.45	$126.48	$127.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.66 / $155.66 / $155.66	Professional		$155.66	$155.66	$155.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.63 / $129.63 / $129.63	Facility		$129.63	$129.63	$129.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $161.80 / $282.19	Professional		$94.64	$161.80	$282.19
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $111.13 / $140.61 / $140.61	Facility		$111.13	$140.61	$140.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $108.74 / $140.61 / $204.31	Professional		$108.74	$140.61	$204.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $144.00 / $165.60	Professional		$122.40	$144.00	$165.60
United Facility/Professional Professional Modifier Low / Median / High Price $72.27 / $91.38 / $139.27	Professional		$72.27	$91.38	$139.27