Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.21 / $216.21 / $216.21	Facility		$216.21	$216.21	$216.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.59 / $216.21 / $240.96	Professional		$195.59	$216.21	$240.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $573.02 / $1,141.68 / $2,079.37	Facility		$573.02	$1,141.68	$2,079.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $359.66 / $378.59 / $511.10	Professional		$359.66	$378.59	$511.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $246.08 / $246.08 / $246.08	Facility		$246.08	$246.08	$246.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $302.87 / $302.87 / $302.87	Professional		$302.87	$302.87	$302.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $236.57 / $236.57 / $236.57	Facility		$236.57	$236.57	$236.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.56 / $236.57 / $438.75	Professional		$236.56	$236.57	$438.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $216.21 / $273.58 / $273.58	Facility		$216.21	$273.58	$273.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $216.21 / $273.58 / $402.15	Professional		$216.21	$273.58	$402.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $229.73 / $280.16 / $322.18	Professional		$229.73	$280.16	$322.18
United Facility/Professional Professional Modifier Low / Median / High Price $147.88 / $181.00 / $270.97	Professional		$147.88	$181.00	$270.97