Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.44 / $123.44 / $123.44	Facility		$123.44	$123.44	$123.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.54 / $123.44 / $123.44	Professional		$102.54	$123.44	$123.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $327.17 / $651.85 / $1,187.24	Facility		$327.17	$651.85	$1,187.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.35 / $216.16 / $291.82	Professional		$205.35	$216.16	$291.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $137.12 / $140.50 / $141.26	Facility		$137.12	$140.50	$141.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $172.93 / $172.93 / $172.93	Professional		$172.93	$172.93	$172.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.65 / $171.65 / $171.65	Facility		$171.65	$171.65	$171.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $171.65 / $250.50	Professional		$88.00	$171.65	$250.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $123.44 / $156.21 / $156.21	Facility		$123.44	$156.21	$156.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $123.44 / $156.21 / $243.12	Professional		$123.44	$156.21	$243.12
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 $80.30 / $103.34 / $160.60	Professional		$80.30	$103.34	$160.60