Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.26 / $110.26 / $110.26	Facility		$110.26	$110.26	$110.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.59 / $110.26 / $110.26	Professional		$91.59	$110.26	$110.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $292.24 / $582.25 / $1,060.47	Facility		$292.24	$582.25	$1,060.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.43 / $193.08 / $260.66	Professional		$183.43	$193.08	$260.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $122.49 / $125.50 / $126.18	Facility		$122.49	$125.50	$126.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.46 / $154.46 / $154.46	Professional		$154.46	$154.46	$154.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.78 / $107.78 / $107.78	Facility		$107.78	$107.78	$107.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $107.78 / $223.88	Professional		$97.62	$107.78	$223.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $110.26 / $139.51 / $139.51	Facility		$110.26	$139.51	$139.51
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $110.26 / $139.51 / $202.73	Professional		$110.26	$139.51	$202.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $121.44 / $142.88 / $164.31	Professional		$121.44	$142.88	$164.31
United Facility/Professional Facility Modifier Low / Median / High Price $1.42 / $85.28 / $109.18	Facility		$1.42	$85.28	$109.18
United Facility/Professional Professional Modifier Low / Median / High Price $67.38 / $89.05 / $131.68	Professional		$67.38	$89.05	$131.68