Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $369.85 / $369.85 / $369.85	Facility		$369.85	$369.85	$369.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.95 / $369.85 / $369.85	Professional		$279.95	$369.85	$369.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $980.23 / $1,952.99 / $3,557.04	Facility		$980.23	$1,952.99	$3,557.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $615.25 / $647.63 / $874.30	Professional		$615.25	$647.63	$874.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $337.35 / $352.24 / $420.96	Facility		$337.35	$352.24	$420.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $518.10 / $518.10 / $518.10	Professional		$518.10	$518.10	$518.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $324.30 / $324.30 / $324.30	Facility		$324.30	$324.30	$324.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.74 / $538.48 / $938.44	Professional		$236.74	$538.48	$938.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $369.85 / $468.00 / $468.00	Facility		$369.85	$468.00	$468.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $366.43 / $468.00 / $680.01	Professional		$366.43	$468.00	$680.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $392.98 / $479.25 / $551.13	Professional		$392.98	$479.25	$551.13
United Facility/Professional Professional Modifier Low / Median / High Price $215.39 / $292.01 / $431.54	Professional		$215.39	$292.01	$431.54