Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.39 / $182.39 / $182.39	Facility		$182.39	$182.39	$182.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.94 / $182.39 / $182.39	Professional		$155.94	$182.39	$182.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $483.39 / $963.09 / $1,754.11	Facility		$483.39	$963.09	$1,754.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.39 / $319.37 / $431.15	Professional		$303.39	$319.37	$431.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.16 / $207.59 / $233.12	Facility		$186.16	$207.59	$233.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $255.50 / $255.50 / $255.50	Professional		$255.50	$255.50	$255.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.54 / $170.54 / $170.54	Facility		$170.54	$170.54	$170.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.54 / $170.54 / $370.13	Professional		$170.54	$170.54	$370.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $182.39 / $230.79 / $230.79	Facility		$182.39	$230.79	$230.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $182.39 / $230.79 / $359.21	Professional		$182.39	$230.79	$359.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $113.47 / $152.68 / $228.58	Professional		$113.47	$152.68	$228.58