Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.34 / $138.34 / $138.34	Facility		$138.34	$138.34	$138.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.91 / $138.34 / $138.34	Professional		$114.91	$138.34	$138.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $366.63 / $730.47 / $1,330.42	Facility		$366.63	$730.47	$1,330.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.12 / $242.23 / $327.01	Professional		$230.12	$242.23	$327.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $153.66 / $157.44 / $158.34	Facility		$153.66	$157.44	$158.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $193.78 / $193.78 / $193.78	Professional		$193.78	$193.78	$193.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.22 / $135.22 / $135.22	Facility		$135.22	$135.22	$135.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.22 / $135.22 / $280.88	Professional		$135.22	$135.22	$280.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $138.34 / $175.06 / $175.06	Facility		$138.34	$175.06	$175.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $138.34 / $175.06 / $254.34	Professional		$138.34	$175.06	$254.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $84.54 / $113.76 / $173.38	Professional		$84.54	$113.76	$173.38