Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.12 / $86.12 / $86.12	Facility		$86.12	$86.12	$86.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $86.12 / $86.12	Professional		$71.77	$86.12	$86.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $228.24 / $454.75 / $828.25	Facility		$228.24	$454.75	$828.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.26 / $150.80 / $203.58	Professional		$143.26	$150.80	$203.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.61 / $98.02 / $108.30	Facility		$94.61	$98.02	$108.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.64 / $120.64 / $120.64	Professional		$120.64	$120.64	$120.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.54 / $97.54 / $97.54	Facility		$97.54	$97.54	$97.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.54 / $97.54 / $174.75	Professional		$97.54	$97.54	$174.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $86.12 / $108.97 / $108.97	Facility		$86.12	$108.97	$108.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $86.12 / $108.97 / $158.34	Professional		$86.12	$108.97	$158.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.50 / $111.59 / $128.32	Professional		$91.50	$111.59	$128.32
United Facility/Professional Professional Modifier Low / Median / High Price $60.52 / $72.62 / $111.90	Professional		$60.52	$72.62	$111.90