Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $492.37 / $492.37 / $768.10	Facility		$492.37	$492.37	$768.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $440.54 / $492.37 / $518.28	Professional		$440.54	$492.37	$518.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.07 / $388.71 / $388.71	Facility		$11.07	$388.71	$388.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $369.27 / $388.71 / $415.92	Professional		$369.27	$388.71	$415.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $518.28 / $769.78 / $1,243.86	Facility		$518.28	$769.78	$1,243.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $518.28 / $647.85 / $699.68	Professional		$518.28	$647.85	$699.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.19 / $290.26 / $720.95	Professional		$245.19	$290.26	$720.95
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $492.37 / $492.37 / $904.73	Facility		$492.37	$492.37	$904.73
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $492.37 / $497.55 / $621.94	Professional		$492.37	$497.55	$621.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $429.13 / $472.04 / $772.43	Professional		$429.13	$472.04	$772.43
United Facility/Professional Professional Modifier Low / Median / High Price $217.68 / $310.97 / $518.28	Professional		$217.68	$310.97	$518.28