Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.78 / $111.78 / $111.78	Facility		$111.78	$111.78	$111.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.58 / $111.78 / $112.01	Professional		$95.58	$111.78	$112.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $296.25 / $590.24 / $1,075.03	Facility		$296.25	$590.24	$1,075.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.94 / $195.73 / $264.24	Professional		$185.94	$195.73	$264.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.22 / $130.63 / $148.47	Facility		$127.22	$130.63	$148.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $156.58 / $156.58 / $156.58	Professional		$156.58	$156.58	$156.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $122.31 / $122.31 / $122.31	Facility		$122.31	$122.31	$122.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.31 / $122.31 / $226.88	Professional		$122.31	$122.31	$226.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $111.78 / $141.44 / $141.44	Facility		$111.78	$141.44	$141.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $141.44 / $205.51	Professional		$111.78	$141.44	$205.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.76 / $144.84 / $166.56	Professional		$118.76	$144.84	$166.56
United Facility/Professional Professional Modifier Low / Median / High Price $81.38 / $97.65 / $150.47	Professional		$81.38	$97.65	$150.47