Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.09 / $219.09 / $219.09	Facility		$219.09	$219.09	$219.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.43 / $219.09 / $219.09	Professional		$162.43	$219.09	$219.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $580.66 / $1,156.90 / $2,107.10	Facility		$580.66	$1,156.90	$2,107.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $364.46 / $383.64 / $517.91	Professional		$364.46	$383.64	$517.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $187.02 / $200.69 / $249.37	Facility		$187.02	$200.69	$249.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $306.91 / $306.91 / $306.91	Professional		$306.91	$306.91	$306.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.30 / $225.30 / $225.30	Facility		$225.30	$225.30	$225.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.30 / $225.30 / $444.75	Professional		$225.30	$225.30	$444.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $219.09 / $277.23 / $277.23	Facility		$219.09	$277.23	$277.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $219.09 / $277.23 / $431.50	Professional		$219.09	$277.23	$431.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $137.57	Professional		$30.00	$30.00	$137.57
United Facility/Professional Facility Modifier Low / Median / High Price $326.08 / $383.64 / $383.64	Facility		$326.08	$383.64	$383.64
United Facility/Professional Professional Modifier Low / Median / High Price $112.39 / $176.96 / $271.14	Professional		$112.39	$176.96	$271.14