Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $332.88 / $332.88 / $332.88	Facility		$332.88	$332.88	$332.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.50 / $332.88 / $332.88	Professional		$276.50	$332.88	$332.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $882.23 / $1,757.73 / $3,201.41	Facility		$882.23	$1,757.73	$3,201.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $553.74 / $582.88 / $786.89	Professional		$553.74	$582.88	$786.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $369.79 / $378.87 / $380.94	Facility		$369.79	$378.87	$380.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $466.30 / $466.30 / $466.30	Professional		$466.30	$466.30	$466.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $325.37 / $325.37 / $325.37	Facility		$325.37	$325.37	$325.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.52 / $325.37 / $675.75	Professional		$294.52	$325.37	$675.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $332.88 / $421.22 / $421.22	Facility		$332.88	$421.22	$421.22
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $326.67 / $421.22 / $612.02	Professional		$326.67	$421.22	$612.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $366.63 / $431.33 / $496.02	Professional		$366.63	$431.33	$496.02
United Facility/Professional Professional Modifier Low / Median / High Price $203.40 / $273.73 / $417.19	Professional		$203.40	$273.73	$417.19