Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.75 / $211.43 / $659.66	Facility		$210.75	$211.43	$659.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $210.75 / $1,454.18	Professional		$204.61	$210.75	$1,454.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,916.29 / $2,235.94 / $3,144.89	Facility		$1,916.29	$2,235.94	$3,144.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $130.29 / $208.47	Professional		$39.61	$130.29	$208.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $247.14 / $247.14 / $247.14	Professional		$247.14	$247.14	$247.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.06 / $200.06 / $204.61	Facility		$200.06	$200.06	$204.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $242.78	Professional		$204.61	$204.61	$242.78
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $264.29 / $659.66	Facility		$204.61	$264.29	$659.66
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $210.75 / $412.29	Professional		$204.61	$210.75	$412.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.32 / $205.24 / $235.30	Professional		$168.32	$205.24	$235.30
United Facility/Professional Professional Modifier Low / Median / High Price $157.02 / $204.61 / $204.61	Professional		$157.02	$204.61	$204.61