Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.16 / $135.16 / $135.16	Facility		$135.16	$135.16	$135.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.91 / $135.16 / $135.16	Professional		$110.91	$135.16	$135.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $358.23 / $713.73 / $1,299.94	Facility		$358.23	$713.73	$1,299.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.85 / $236.68 / $319.52	Professional		$224.85	$236.68	$319.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.16 / $146.62 / $153.84	Facility		$125.16	$146.62	$153.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $189.34 / $189.34 / $189.34	Professional		$189.34	$189.34	$189.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.98 / $126.98 / $126.98	Facility		$126.98	$126.98	$126.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $196.79 / $343.13	Professional		$92.70	$196.79	$343.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $135.16 / $171.03 / $171.03	Facility		$135.16	$171.03	$171.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $135.16 / $171.03 / $266.19	Professional		$135.16	$171.03	$266.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $86.47	Professional		$30.00	$30.00	$86.47
United Facility/Professional Facility Modifier Low / Median / High Price $120.51 / $120.51 / $120.51	Facility		$120.51	$120.51	$120.51
United Facility/Professional Professional Modifier Low / Median / High Price $80.05 / $113.15 / $169.40	Professional		$80.05	$113.15	$169.40