Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.57 / $130.57 / $130.57	Facility		$130.57	$130.57	$130.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.58 / $125.61 / $130.57	Professional		$110.58	$125.61	$130.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.04 / $689.46 / $1,255.73	Facility		$346.04	$689.46	$1,255.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.20 / $228.63 / $308.64	Professional		$217.20	$228.63	$308.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $130.66 / $145.94 / $148.61	Facility		$130.66	$145.94	$148.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $182.90 / $182.90 / $182.90	Professional		$182.90	$182.90	$182.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.61 / $125.61 / $125.61	Facility		$125.61	$125.61	$125.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.70 / $190.10 / $331.41	Professional		$91.70	$190.10	$331.41
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $130.57 / $165.21 / $165.21	Facility		$130.57	$165.21	$165.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $120.73 / $165.21 / $240.06	Professional		$120.73	$165.21	$240.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $143.81 / $169.19 / $194.56	Professional		$143.81	$169.19	$194.56
United Facility/Professional Professional Modifier Low / Median / High Price $78.52 / $107.36 / $167.15	Professional		$78.52	$107.36	$167.15