Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $298.60 / $298.60 / $298.60	Facility		$298.60	$298.60	$298.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $270.12 / $298.60 / $298.60	Professional		$270.12	$298.60	$298.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $791.38 / $1,576.74 / $2,871.76	Facility		$791.38	$1,576.74	$2,871.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $496.72 / $522.86 / $705.86	Professional		$496.72	$522.86	$705.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $339.86 / $339.86 / $440.85	Facility		$339.86	$339.86	$440.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $418.29 / $418.29 / $418.29	Professional		$418.29	$418.29	$418.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.35 / $373.35 / $373.35	Facility		$373.35	$373.35	$373.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.35 / $373.35 / $606.00	Professional		$373.35	$373.35	$606.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $298.60 / $377.84 / $377.84	Facility		$298.60	$377.84	$377.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $298.60 / $377.84 / $601.28	Professional		$298.60	$377.84	$601.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $317.27 / $386.92 / $444.95	Professional		$317.27	$386.92	$444.95
United Facility/Professional Professional Modifier Low / Median / High Price $204.24 / $249.96 / $374.22	Professional		$204.24	$249.96	$374.22