Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $196.31 / $196.31 / $196.31	Facility		$196.31	$196.31	$196.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.14 / $196.31 / $196.31	Professional		$170.14	$196.31	$196.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $520.29 / $1,036.64 / $1,888.07	Facility		$520.29	$1,036.64	$1,888.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.57 / $343.76 / $464.08	Professional		$326.57	$343.76	$464.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $197.55 / $221.49 / $223.44	Facility		$197.55	$221.49	$223.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.01 / $275.01 / $275.01	Professional		$275.01	$275.01	$275.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $189.91 / $189.91 / $189.91	Facility		$189.91	$189.91	$189.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.91 / $189.91 / $398.63	Professional		$189.91	$189.91	$398.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $196.31 / $248.41 / $248.41	Facility		$196.31	$248.41	$248.41
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $196.31 / $248.41 / $360.94	Professional		$196.31	$248.41	$360.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.22 / $254.38 / $292.53	Professional		$216.22	$254.38	$292.53
United Facility/Professional Professional Modifier Low / Median / High Price $126.35 / $161.41 / $246.04	Professional		$126.35	$161.41	$246.04