Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.64 / $238.64 / $238.64	Facility		$238.64	$238.64	$238.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.23 / $238.64 / $238.64	Professional		$198.23	$238.64	$238.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $632.46 / $1,260.09 / $2,295.05	Facility		$632.46	$1,260.09	$2,295.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $396.97 / $417.86 / $564.11	Professional		$396.97	$417.86	$564.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $265.10 / $271.61 / $273.08	Facility		$265.10	$271.61	$273.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $334.29 / $334.29 / $334.29	Professional		$334.29	$334.29	$334.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $233.26 / $233.26 / $233.26	Facility		$233.26	$233.26	$233.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.28 / $347.45 / $605.63	Professional		$170.28	$347.45	$605.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $238.64 / $301.98 / $301.98	Facility		$238.64	$301.98	$301.98
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $224.44 / $301.98 / $438.75	Professional		$224.44	$301.98	$438.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $253.56 / $309.22 / $355.60	Professional		$253.56	$309.22	$355.60
United Facility/Professional Professional Modifier Low / Median / High Price $145.82 / $196.24 / $299.08	Professional		$145.82	$196.24	$299.08