Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.31 / $197.31 / $197.31	Facility		$197.31	$197.31	$197.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.90 / $197.31 / $197.31	Professional		$163.90	$197.31	$197.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $522.94 / $1,041.89 / $1,897.62	Facility		$522.94	$1,041.89	$1,897.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $328.22 / $345.50 / $466.43	Professional		$328.22	$345.50	$466.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $219.20 / $224.58 / $225.80	Facility		$219.20	$224.58	$225.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $276.39 / $276.39 / $276.39	Professional		$276.39	$276.39	$276.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.91 / $192.91 / $192.91	Facility		$192.91	$192.91	$192.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.62 / $192.91 / $400.50	Professional		$174.62	$192.91	$400.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $197.31 / $249.68 / $249.68	Facility		$197.31	$249.68	$249.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $193.06 / $249.68 / $362.77	Professional		$193.06	$249.68	$362.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.31 / $255.67 / $294.02	Professional		$217.31	$255.67	$294.02
United Facility/Professional Professional Modifier Low / Median / High Price $120.60 / $165.17 / $247.29	Professional		$120.60	$165.17	$247.29