Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.58 / $310.58 / $310.58	Facility		$310.58	$310.58	$310.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.10 / $310.58 / $343.31	Professional		$292.10	$310.58	$343.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $823.14 / $1,640.00 / $2,986.99	Facility		$823.14	$1,640.00	$2,986.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $516.65 / $543.84 / $734.18	Professional		$516.65	$543.84	$734.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $344.34 / $353.50 / $410.51	Facility		$344.34	$353.50	$410.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $435.07 / $435.07 / $435.07	Professional		$435.07	$435.07	$435.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.03 / $331.03 / $331.03	Facility		$331.03	$331.03	$331.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.03 / $331.03 / $630.38	Professional		$331.03	$331.03	$630.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $310.58 / $393.01 / $393.01	Facility		$310.58	$393.01	$393.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $310.58 / $393.01 / $611.66	Professional		$310.58	$393.01	$611.66
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 $206.94 / $259.99 / $389.25	Professional		$206.94	$259.99	$389.25