Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.69 / $137.69 / $137.69	Facility		$137.69	$137.69	$137.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.67 / $137.69 / $137.69	Professional		$107.67	$137.69	$137.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $364.94 / $727.09 / $1,324.27	Facility		$364.94	$727.09	$1,324.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.05 / $241.11 / $325.50	Professional		$229.05	$241.11	$325.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $132.69 / $132.69 / $156.72	Facility		$132.69	$132.69	$156.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $192.89 / $192.89 / $192.89	Professional		$192.89	$192.89	$192.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.15 / $170.15 / $170.15	Facility		$170.15	$170.15	$170.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.15 / $170.15 / $279.38	Professional		$170.15	$170.15	$279.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $137.69 / $174.24 / $174.24	Facility		$137.69	$174.24	$174.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $122.77 / $174.24 / $259.08	Professional		$122.77	$174.24	$259.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $146.30 / $178.42 / $205.18	Professional		$146.30	$178.42	$205.18
United Facility/Professional Professional Modifier Low / Median / High Price $84.87 / $115.27 / $170.41	Professional		$84.87	$115.27	$170.41