Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.08 / $91.08 / $351.00	Facility		$91.08	$91.08	$351.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.88 / $91.08 / $91.68	Professional		$77.88	$91.08	$91.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $241.38 / $480.93 / $875.93	Facility		$241.38	$480.93	$875.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.51 / $159.47 / $215.30	Professional		$151.51	$159.47	$215.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.66 / $103.66 / $107.10	Facility		$103.66	$103.66	$107.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $127.58 / $127.58 / $127.58	Professional		$127.58	$127.58	$127.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.66 / $99.66 / $99.66	Facility		$99.66	$99.66	$99.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.66 / $99.66 / $184.88	Professional		$99.66	$99.66	$184.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $115.25 / $175.50 / $351.00	Facility		$115.25	$175.50	$351.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $91.08 / $115.25 / $182.05	Professional		$91.08	$115.25	$182.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.77 / $118.02 / $135.72	Professional		$96.77	$118.02	$135.72
United Facility/Professional Professional Modifier Low / Median / High Price $66.31 / $79.56 / $122.61	Professional		$66.31	$79.56	$122.61