Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.57 / $140.57 / $140.57	Facility		$140.57	$140.57	$140.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.48 / $140.57 / $140.57	Professional		$115.48	$140.57	$140.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $372.55 / $742.26 / $1,351.90	Facility		$372.55	$742.26	$1,351.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.83 / $246.14 / $332.29	Professional		$233.83	$246.14	$332.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $150.44 / $153.08 / $159.99	Facility		$150.44	$153.08	$159.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $196.91 / $196.91 / $196.91	Professional		$196.91	$196.91	$196.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.22 / $159.22 / $159.22	Facility		$159.22	$159.22	$159.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.22 / $159.22 / $285.38	Professional		$159.22	$159.22	$285.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $140.57 / $177.87 / $177.87	Facility		$140.57	$177.87	$177.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $140.57 / $177.87 / $258.44	Professional		$140.57	$177.87	$258.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $149.35 / $182.14 / $209.46	Professional		$149.35	$182.14	$209.46
United Facility/Professional Professional Modifier Low / Median / High Price $93.08 / $117.67 / $176.16	Professional		$93.08	$117.67	$176.16