Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.42 / $193.42 / $193.42	Facility		$193.42	$193.42	$193.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.71 / $193.42 / $193.42	Professional		$153.71	$193.42	$193.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.63 / $1,021.35 / $1,860.22	Facility		$512.63	$1,021.35	$1,860.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $321.76 / $338.69 / $457.23	Professional		$321.76	$338.69	$457.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.15 / $194.72 / $220.15	Facility		$169.15	$194.72	$220.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $270.95 / $270.95 / $270.95	Professional		$270.95	$270.95	$270.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.91 / $159.91 / $159.91	Facility		$159.91	$159.91	$159.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.74 / $281.62 / $490.78	Professional		$116.74	$281.62	$490.78
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $193.42 / $244.76 / $244.76	Facility		$193.42	$244.76	$244.76
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $189.09 / $244.76 / $355.62	Professional		$189.09	$244.76	$355.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $205.51 / $250.63 / $288.22	Professional		$205.51	$250.63	$288.22
United Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $156.22 / $225.30	Professional		$99.97	$156.22	$225.30