Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $574.00 / $574.00 / $574.00	Facility		$574.00	$574.00	$574.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $574.00 / $574.00 / $574.00	Professional		$574.00	$574.00	$574.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $866.40 / $1,155.20 / $1,512.76	Facility		$866.40	$1,155.20	$1,512.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.02 / $32.71 / $425.25	Professional		$23.02	$32.71	$425.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $157.94 / $157.94 / $157.94	Facility		$157.94	$157.94	$157.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.00 / $424.00 / $424.00	Facility		$424.00	$424.00	$424.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.65 / $424.00 / $436.72	Professional		$123.65	$424.00	$436.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $158.97 / $574.00 / $574.00	Professional		$158.97	$574.00	$574.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.66 / $30.00 / $264.95	Professional		$17.66	$30.00	$264.95