Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.84 / $389.84 / $389.84	Facility		$389.84	$389.84	$389.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.91 / $337.00 / $389.84	Professional		$256.91	$337.00	$389.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,389.72 / $1,852.94 / $2,426.46	Facility		$1,389.72	$1,852.94	$2,426.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.93 / $480.00 / $682.10	Professional		$36.93	$480.00	$682.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.63 / $41.05 / $379.43	Facility		$29.63	$41.05	$379.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $50.52 / $527.88	Professional		$38.50	$50.52	$527.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $256.50 / $256.50 / $386.04	Facility		$256.50	$256.50	$386.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.50 / $386.04 / $562.50	Professional		$256.50	$386.04	$562.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $48.12 / $340.73 / $481.20	Professional		$48.12	$340.73	$481.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.81 / $48.42 / $440.22	Professional		$30.81	$48.42	$440.22
United Facility/Professional Professional Modifier Low / Median / High Price $152.66 / $206.30 / $320.95	Professional		$152.66	$206.30	$320.95