Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.79 / $62.79 / $62.79	Facility		$62.79	$62.79	$62.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.54 / $62.79 / $82.90	Professional		$56.54	$62.79	$82.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $681.10 / $1,357.02 / $2,517.25	Facility		$681.10	$1,357.02	$2,517.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $427.50 / $450.00 / $607.50	Professional		$427.50	$450.00	$607.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.57 / $140.57 / $270.54	Facility		$140.57	$140.57	$270.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $204.62 / $204.62 / $204.62	Professional		$204.62	$204.62	$204.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.08 / $139.08 / $139.08	Facility		$139.08	$139.08	$139.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.53 / $152.76 / $250.58	Professional		$101.53	$152.76	$250.58
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $62.79 / $110.96 / $110.96	Facility		$62.79	$110.96	$110.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $62.79 / $110.96 / $144.82	Professional		$62.79	$110.96	$144.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.84 / $152.76 / $229.14	Professional		$129.84	$152.76	$229.14
United Facility/Professional Professional Modifier Low / Median / High Price $52.77 / $73.40 / $122.34	Professional		$52.77	$73.40	$122.34