Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.68 / $163.68 / $163.68	Facility		$163.68	$163.68	$163.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $163.68 / $165.27	Professional		$158.91	$163.68	$165.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $161.90 / $161.90 / $161.90	Facility		$161.90	$161.90	$161.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.81 / $161.90 / $218.57	Professional		$153.81	$161.90	$218.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.30 / $103.30 / $103.30	Facility		$103.30	$103.30	$103.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $127.14 / $127.14 / $127.14	Professional		$127.14	$127.14	$127.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.91 / $152.91 / $158.91	Facility		$152.91	$152.91	$158.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.18 / $158.91 / $158.91	Professional		$147.18	$158.91	$158.91
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $163.68 / $238.38	Facility		$158.91	$163.68	$238.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $153.59 / $158.91 / $190.70	Professional		$153.59	$158.91	$190.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $126.45 / $148.76	Professional		$30.00	$126.45	$148.76
United Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $158.91 / $174.81	Professional		$63.57	$158.91	$174.81