Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.40 / $247.40 / $247.40	Facility		$247.40	$247.40	$247.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.40 / $247.40 / $312.45	Professional		$247.40	$247.40	$312.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $307.13 / $307.13 / $307.13	Facility		$307.13	$307.13	$307.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.83 / $170.83 / $170.83	Facility		$170.83	$170.83	$170.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.83 / $170.83 / $170.83	Professional		$170.83	$170.83	$170.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $247.40 / $247.40 / $257.39	Professional		$247.40	$247.40	$257.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00