Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.83 / $180.83 / $323.27	Facility		$180.83	$180.83	$323.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.19 / $170.07 / $180.83	Professional		$150.19	$170.07	$180.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $479.26 / $954.86 / $1,739.11	Facility		$479.26	$954.86	$1,739.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $300.81 / $316.64 / $427.46	Professional		$300.81	$316.64	$427.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $200.87 / $205.82 / $206.93	Facility		$200.87	$205.82	$206.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $253.31 / $253.31 / $253.31	Professional		$253.31	$253.31	$253.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.75 / $176.75 / $180.09	Facility		$176.75	$176.75	$180.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.31 / $176.75 / $367.13	Professional		$160.31	$176.75	$367.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $180.83 / $228.81 / $323.27	Facility		$180.83	$228.81	$323.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $169.87 / $228.81 / $332.47	Professional		$169.87	$228.81	$332.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.16 / $234.31 / $269.45	Professional		$199.16	$234.31	$269.45
United Facility/Professional Professional Modifier Low / Median / High Price $110.49 / $148.69 / $226.62	Professional		$110.49	$148.69	$226.62