Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $312.25 / $312.25 / $312.25	Facility		$312.25	$312.25	$312.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.56 / $312.25 / $312.25	Professional		$250.56	$312.25	$312.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $827.56 / $1,648.81 / $3,003.02	Facility		$827.56	$1,648.81	$3,003.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $519.41 / $546.76 / $738.13	Professional		$519.41	$546.76	$738.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $309.60 / $309.60 / $355.39	Facility		$309.60	$309.60	$355.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $437.41 / $437.41 / $437.41	Professional		$437.41	$437.41	$437.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.62 / $297.62 / $297.62	Facility		$297.62	$297.62	$297.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.62 / $297.62 / $633.75	Professional		$297.62	$297.62	$633.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $312.25 / $395.12 / $395.12	Facility		$312.25	$395.12	$395.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $299.20 / $395.12 / $574.09	Professional		$299.20	$395.12	$574.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $331.77 / $404.60 / $465.29	Professional		$331.77	$404.60	$465.29
United Facility/Professional Professional Modifier Low / Median / High Price $186.06 / $256.76 / $386.58	Professional		$186.06	$256.76	$386.58