Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.43 / $102.43 / $102.43	Facility		$102.43	$102.43	$102.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.38 / $102.43 / $102.43	Professional		$78.38	$102.43	$102.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.48 / $540.88 / $985.12	Facility		$271.48	$540.88	$985.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.39 / $179.36 / $242.14	Professional		$170.39	$179.36	$242.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.90 / $116.58 / $116.83	Facility		$103.90	$116.58	$116.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $143.49 / $143.49 / $143.49	Professional		$143.49	$143.49	$143.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.25 / $113.25 / $113.25	Facility		$113.25	$113.25	$113.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.25 / $113.25 / $207.75	Professional		$113.25	$113.25	$207.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $102.43 / $129.63 / $129.63	Facility		$102.43	$129.63	$129.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $101.49 / $129.63 / $194.58	Professional		$101.49	$129.63	$194.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.83 / $132.72 / $152.63	Professional		$108.83	$132.72	$152.63
United Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $85.75 / $128.38	Professional		$66.45	$85.75	$128.38