Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.18 / $111.18 / $111.18	Facility		$111.18	$111.18	$111.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.65 / $111.18 / $111.18	Professional		$92.65	$111.18	$111.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.66 / $587.08 / $1,069.26	Facility		$294.66	$587.08	$1,069.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.95 / $194.68 / $262.82	Professional		$184.95	$194.68	$262.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.51 / $126.54 / $127.21	Facility		$123.51	$126.54	$127.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $155.74 / $155.74 / $155.74	Professional		$155.74	$155.74	$155.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.73 / $67.73 / $67.73	Facility		$67.73	$67.73	$67.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $67.73 / $225.75	Professional		$67.73	$67.73	$225.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $111.18 / $140.68 / $140.68	Facility		$111.18	$140.68	$140.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $111.18 / $140.68 / $218.97	Professional		$111.18	$140.68	$218.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $93.07 / $139.33	Professional		$72.31	$93.07	$139.33