Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $160.96 / $160.96	Facility		$160.96	$160.96	$160.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.16 / $160.96 / $160.96	Professional		$109.16	$160.96	$160.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $849.92 / $1,547.98	Facility		$426.58	$849.92	$1,547.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.75 / $281.83 / $380.48	Professional		$267.75	$281.83	$380.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $144.50 / $144.69 / $183.20	Facility		$144.50	$144.69	$183.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $225.47 / $225.47 / $225.47	Professional		$225.47	$225.47	$225.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.31 / $182.31 / $182.31	Facility		$182.31	$182.31	$182.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.31 / $182.31 / $326.63	Professional		$182.31	$182.31	$326.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $203.68 / $203.68	Facility		$160.96	$203.68	$203.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $149.56 / $203.68 / $295.93	Professional		$149.56	$203.68	$295.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $171.01 / $208.56 / $239.84	Professional		$171.01	$208.56	$239.84
United Facility/Professional Professional Modifier Low / Median / High Price $93.74 / $132.35 / $187.47	Professional		$93.74	$132.35	$187.47