Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.36 / $142.36 / $142.36	Facility		$142.36	$142.36	$142.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.21 / $142.36 / $142.36	Professional		$111.21	$142.36	$142.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $377.29 / $751.70 / $1,369.09	Facility		$377.29	$751.70	$1,369.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $236.81 / $249.27 / $336.51	Professional		$236.81	$249.27	$336.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $137.41 / $155.74 / $162.03	Facility		$137.41	$155.74	$162.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $199.42 / $199.42 / $199.42	Professional		$199.42	$199.42	$199.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.47 / $166.47 / $166.47	Facility		$166.47	$166.47	$166.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.47 / $166.47 / $289.13	Professional		$166.47	$166.47	$289.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $142.36 / $180.14 / $180.14	Facility		$142.36	$180.14	$180.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $141.05 / $180.14 / $261.73	Professional		$141.05	$180.14	$261.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.25 / $184.46 / $212.12	Professional		$151.25	$184.46	$212.12
United Facility/Professional Professional Modifier Low / Median / High Price $94.90 / $119.17 / $178.42	Professional		$94.90	$119.17	$178.42