Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.00 / $172.00 / $172.00	Facility		$172.00	$172.00	$172.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.59 / $172.00 / $195.17	Professional		$155.59	$172.00	$195.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $455.84 / $908.21 / $1,654.15	Facility		$455.84	$908.21	$1,654.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.11 / $301.17 / $406.58	Professional		$286.11	$301.17	$406.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $195.76 / $195.76 / $195.76	Facility		$195.76	$195.76	$195.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $240.94 / $240.94 / $240.94	Professional		$240.94	$240.94	$240.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.19 / $188.19 / $188.19	Facility		$188.19	$188.19	$188.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.41 / $188.19 / $349.13	Professional		$170.41	$188.19	$349.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $172.00 / $217.64 / $217.64	Facility		$172.00	$217.64	$217.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $172.00 / $217.64 / $316.22	Professional		$172.00	$217.64	$316.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $182.75 / $222.87 / $256.30	Professional		$182.75	$222.87	$256.30
United Facility/Professional Professional Modifier Low / Median / High Price $117.64 / $149.91 / $215.55	Professional		$117.64	$149.91	$215.55