Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.71 / $133.71 / $133.71	Facility		$133.71	$133.71	$133.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.14 / $133.71 / $133.71	Professional		$88.14	$133.71	$133.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.37 / $706.04 / $1,285.94	Facility		$354.37	$706.04	$1,285.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.42 / $234.13 / $316.08	Professional		$222.42	$234.13	$316.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.14 / $114.14 / $152.18	Facility		$114.14	$114.14	$152.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $187.30 / $187.30 / $187.30	Professional		$187.30	$187.30	$187.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $113.00 / $113.00	Facility		$113.00	$113.00	$113.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $113.00 / $271.50	Professional		$113.00	$113.00	$271.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $133.71 / $169.20 / $169.20	Facility		$133.71	$169.20	$169.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $133.71 / $169.20 / $259.00	Professional		$133.71	$169.20	$259.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $75.36	Professional		$30.00	$30.00	$75.36
United Facility/Professional Professional Modifier Low / Median / High Price $73.01 / $111.93 / $167.58	Professional		$73.01	$111.93	$167.58