Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $403.85 / $405.69 / $1,265.75	Facility		$403.85	$405.69	$1,265.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.09 / $403.85 / $435.61	Professional		$392.09	$403.85	$435.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $472.35 / $873.14 / $1,629.48	Facility		$472.35	$873.14	$1,629.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $379.51 / $399.48 / $539.29	Professional		$379.51	$399.48	$539.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $495.46 / $495.46 / $495.46	Professional		$495.46	$495.46	$495.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $392.09 / $392.09 / $401.08	Facility		$392.09	$392.09	$401.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.09 / $392.09 / $413.11	Professional		$392.09	$392.09	$413.11
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $392.09 / $471.86 / $1,128.83	Facility		$392.09	$471.86	$1,128.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $392.09 / $400.94 / $470.50	Professional		$392.09	$400.94	$470.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $322.97 / $393.87 / $433.85	Professional		$322.97	$393.87	$433.85
United Facility/Professional Professional Modifier Low / Median / High Price $156.84 / $392.09 / $401.08	Professional		$156.84	$392.09	$401.08