Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.95 / $218.95 / $218.95	Facility		$218.95	$218.95	$218.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.14 / $218.95 / $223.78	Professional		$191.14	$218.95	$223.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $580.29 / $1,156.18 / $2,105.79	Facility		$580.29	$1,156.18	$2,105.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $364.23 / $383.40 / $517.59	Professional		$364.23	$383.40	$517.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $224.56 / $249.21 / $251.28	Facility		$224.56	$249.21	$251.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $306.72 / $306.72 / $306.72	Professional		$306.72	$306.72	$306.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.87 / $215.87 / $215.87	Facility		$215.87	$215.87	$215.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.87 / $215.87 / $444.38	Professional		$215.87	$215.87	$444.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $218.95 / $277.07 / $277.07	Facility		$218.95	$277.07	$277.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $218.95 / $277.07 / $431.22	Professional		$218.95	$277.07	$431.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $165.19	Professional		$30.00	$30.00	$165.19
United Facility/Professional Professional Modifier Low / Median / High Price $134.94 / $180.05 / $270.95	Professional		$134.94	$180.05	$270.95