Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.72 / $159.72 / $159.72	Facility		$159.72	$159.72	$159.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.57 / $159.72 / $177.22	Professional		$136.57	$159.72	$177.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $423.33 / $843.43 / $1,536.17	Facility		$423.33	$843.43	$1,536.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.70 / $279.69 / $377.58	Professional		$265.70	$279.69	$377.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.80 / $181.80 / $231.97	Facility		$181.80	$181.80	$231.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.75 / $223.75 / $223.75	Professional		$223.75	$223.75	$223.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.77 / $174.77 / $174.77	Facility		$174.77	$174.77	$174.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.77 / $174.77 / $324.38	Professional		$174.77	$174.77	$324.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $159.72 / $202.12 / $202.12	Facility		$159.72	$202.12	$202.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $202.12 / $313.48	Professional		$159.72	$202.12	$313.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $169.71 / $206.97 / $238.01	Professional		$169.71	$206.97	$238.01
United Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $139.54 / $215.02	Professional		$116.28	$139.54	$215.02