Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.44 / $549.44 / $549.44	Facility		$549.44	$549.44	$549.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.53 / $549.44 / $552.50	Professional		$365.53	$549.44	$552.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.96 / $1,377.93 / $3,289.87	Facility		$136.96	$1,377.93	$3,289.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.53 / $539.12 / $970.42	Professional		$52.53	$539.12	$970.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.24 / $44.50 / $535.89	Facility		$41.24	$44.50	$535.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.77 / $54.77 / $821.52	Professional		$54.77	$54.77	$821.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.74 / $316.74 / $316.74	Facility		$316.74	$316.74	$316.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.97 / $316.74 / $625.22	Professional		$58.97	$316.74	$625.22
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $464.45 / $464.45 / $549.44	Facility		$464.45	$464.45	$549.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $68.45 / $500.17 / $684.60	Professional		$68.45	$500.17	$684.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.01 / $68.77 / $625.22	Professional		$50.01	$68.77	$625.22
United Facility/Professional Professional Modifier Low / Median / High Price $217.35 / $281.20 / $508.06	Professional		$217.35	$281.20	$508.06