Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.06 / $122.06 / $122.06	Facility		$122.06	$122.06	$122.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.91 / $122.06 / $161.15	Professional		$109.91	$122.06	$161.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $576.66 / $1,148.94 / $2,092.60	Facility		$576.66	$1,148.94	$2,092.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.95 / $381.00 / $514.35	Professional		$361.95	$381.00	$514.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $203.38 / $203.38 / $203.38	Facility		$203.38	$203.38	$203.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $527.29 / $527.29 / $527.29	Professional		$527.29	$527.29	$527.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $210.68 / $210.68 / $210.68	Facility		$210.68	$210.68	$210.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.29 / $210.68 / $367.72	Professional		$143.29	$210.68	$367.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $122.06 / $215.70 / $215.70	Facility		$122.06	$215.70	$215.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $122.06 / $215.70 / $272.52	Professional		$122.06	$215.70	$272.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $121.79 / $143.29 / $214.93	Professional		$121.79	$143.29	$214.93
United Facility/Professional Professional Modifier Low / Median / High Price $118.92 / $142.50 / $245.02	Professional		$118.92	$142.50	$245.02