Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.98 / $65.98 / $65.98	Facility		$65.98	$65.98	$65.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.74 / $65.98 / $67.40	Professional		$55.74	$65.98	$67.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.86 / $348.39 / $634.54	Facility		$174.86	$348.39	$634.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $115.53 / $155.97	Professional		$109.75	$115.53	$155.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.87 / $75.09 / $83.51	Facility		$68.87	$75.09	$83.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.42 / $92.42 / $92.42	Professional		$92.42	$92.42	$92.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.37 / $66.37 / $66.37	Facility		$66.37	$66.37	$66.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $66.37 / $133.88	Professional		$66.37	$66.37	$133.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $65.98 / $83.48 / $83.48	Facility		$65.98	$83.48	$83.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $83.48 / $121.30	Professional		$65.98	$83.48	$121.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.10 / $85.49 / $98.31	Professional		$70.10	$85.49	$98.31
United Facility/Professional Professional Modifier Low / Median / High Price $40.84 / $54.25 / $82.69	Professional		$40.84	$54.25	$82.69