Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.35 / $124.35 / $124.35	Facility		$124.35	$124.35	$124.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.32 / $124.35 / $141.11	Professional		$106.32	$124.35	$141.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $329.56 / $656.62 / $1,195.92	Facility		$329.56	$656.62	$1,195.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.85 / $217.74 / $293.95	Professional		$206.85	$217.74	$293.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.53 / $141.53 / $141.53	Facility		$141.53	$141.53	$141.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $174.19 / $174.19 / $174.19	Professional		$174.19	$174.19	$174.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.85 / $140.85 / $140.85	Facility		$140.85	$140.85	$140.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.82 / $181.05 / $315.47	Professional		$102.82	$181.05	$315.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $124.35 / $157.35 / $157.35	Facility		$124.35	$157.35	$157.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $124.35 / $157.35 / $228.62	Professional		$124.35	$157.35	$228.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.12 / $161.13 / $185.29	Professional		$132.12	$161.13	$185.29
United Facility/Professional Professional Modifier Low / Median / High Price $90.53 / $108.63 / $167.39	Professional		$90.53	$108.63	$167.39