Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.27 / $84.27 / $84.27	Facility		$84.27	$84.27	$84.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.01 / $84.27 / $84.27	Professional		$70.01	$84.27	$84.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.34 / $444.98 / $810.46	Facility		$223.34	$444.98	$810.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.18 / $147.56 / $199.21	Professional		$140.18	$147.56	$199.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.63 / $95.91 / $96.43	Facility		$93.63	$95.91	$96.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.05 / $118.05 / $118.05	Professional		$118.05	$118.05	$118.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.71 / $83.71 / $83.71	Facility		$83.71	$83.71	$83.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $83.71 / $171.00	Professional		$39.60	$83.71	$171.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $48.80 / $48.80 / $84.27	Facility		$48.80	$48.80	$84.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $48.80 / $84.27 / $154.93	Professional		$48.80	$84.27	$154.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Facility Modifier Low / Median / High Price $1.09 / $65.33 / $83.64	Facility		$1.09	$65.33	$83.64
United Facility/Professional Professional Modifier Low / Median / High Price $51.71 / $69.30 / $115.50	Professional		$51.71	$69.30	$115.50