Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $196.23 / $196.23 / $196.23	Facility		$196.23	$196.23	$196.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.99 / $196.23 / $196.23	Professional		$162.99	$196.23	$196.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $520.05 / $1,036.16 / $1,887.19	Facility		$520.05	$1,036.16	$1,887.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.42 / $343.60 / $463.86	Professional		$326.42	$343.60	$463.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $217.98 / $223.34 / $224.56	Facility		$217.98	$223.34	$224.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $274.88 / $274.88 / $274.88	Professional		$274.88	$274.88	$274.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.25 / $192.25 / $192.25	Facility		$192.25	$192.25	$192.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.25 / $192.25 / $398.25	Professional		$192.25	$192.25	$398.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $196.23 / $248.31 / $248.31	Facility		$196.23	$248.31	$248.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $196.23 / $248.31 / $386.46	Professional		$196.23	$248.31	$386.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $120.18 / $161.36 / $258.23	Professional		$120.18	$161.36	$258.23