Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.97 / $192.97 / $192.97	Facility		$192.97	$192.97	$192.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.96 / $192.97 / $192.97	Professional		$158.96	$192.97	$192.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $511.42 / $1,018.94 / $1,855.83	Facility		$511.42	$1,018.94	$1,855.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $321.00 / $337.89 / $456.15	Professional		$321.00	$337.89	$456.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $195.83 / $199.99 / $219.63	Facility		$195.83	$199.99	$219.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $270.31 / $270.31 / $270.31	Professional		$270.31	$270.31	$270.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.57 / $218.57 / $218.57	Facility		$218.57	$218.57	$218.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.57 / $218.57 / $391.88	Professional		$218.57	$218.57	$391.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $192.97 / $244.17 / $244.17	Facility		$192.97	$244.17	$244.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $192.97 / $244.17 / $380.04	Professional		$192.97	$244.17	$380.04
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 $117.68 / $158.66 / $241.82	Professional		$117.68	$158.66	$241.82