Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.43 / $169.59 / $213.68	Facility		$118.43	$169.59	$213.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.32 / $169.59 / $175.27	Professional		$143.32	$169.59	$175.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $449.47 / $895.51 / $1,631.02	Facility		$449.47	$895.51	$1,631.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.11 / $296.95 / $400.90	Professional		$282.11	$296.95	$400.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $188.41 / $193.02 / $194.10	Facility		$188.41	$193.02	$194.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $237.57 / $237.57 / $237.57	Professional		$237.57	$237.57	$237.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.58 / $176.58 / $176.58	Facility		$176.58	$176.58	$176.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.21 / $176.58 / $344.25	Professional		$150.21	$176.58	$344.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $118.43 / $214.60 / $214.60	Facility		$118.43	$214.60	$214.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $159.50 / $214.60 / $311.80	Professional		$159.50	$214.60	$311.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $186.78 / $219.75 / $252.71	Professional		$186.78	$219.75	$252.71
United Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $139.46 / $209.92	Professional		$103.64	$139.46	$209.92