Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.88 / $119.88 / $119.88	Facility		$119.88	$119.88	$119.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.61 / $119.88 / $119.88	Professional		$99.61	$119.88	$119.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $317.70 / $633.00 / $1,152.91	Facility		$317.70	$633.00	$1,152.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.41 / $209.91 / $283.38	Professional		$199.41	$209.91	$283.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $133.21 / $136.44 / $137.19	Facility		$133.21	$136.44	$137.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $167.93 / $167.93 / $167.93	Professional		$167.93	$167.93	$167.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.11 / $149.11 / $149.11	Facility		$149.11	$149.11	$149.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.11 / $149.11 / $243.38	Professional		$149.11	$149.11	$243.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $119.88 / $151.69 / $151.69	Facility		$119.88	$151.69	$151.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $119.88 / $151.69 / $220.40	Professional		$119.88	$151.69	$220.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.03 / $155.33 / $178.62	Professional		$132.03	$155.33	$178.62
United Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $98.58 / $150.25	Professional		$77.98	$98.58	$150.25