Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.69 / $147.69 / $147.69	Facility		$147.69	$147.69	$147.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.83 / $147.69 / $147.69	Professional		$120.83	$147.69	$147.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $391.45 / $779.92 / $1,420.50	Facility		$391.45	$779.92	$1,420.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.70 / $258.63 / $349.15	Professional		$245.70	$258.63	$349.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $149.51 / $160.16 / $168.11	Facility		$149.51	$160.16	$168.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $206.90 / $206.90 / $206.90	Professional		$206.90	$206.90	$206.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.58 / $175.58 / $175.58	Facility		$175.58	$175.58	$175.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.58 / $175.58 / $300.00	Professional		$175.58	$175.58	$300.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $147.69 / $186.90 / $186.90	Facility		$147.69	$186.90	$186.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $186.90 / $271.56	Professional		$131.69	$186.90	$271.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.93 / $191.39 / $220.09	Professional		$156.93	$191.39	$220.09
United Facility/Professional Professional Modifier Low / Median / High Price $86.69 / $123.64 / $172.80	Professional		$86.69	$123.64	$172.80