Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $332.87 / $332.88 / $332.88	Facility		$332.87	$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 $237.52 / $484.66 / $844.69	Professional		$237.52	$484.66	$844.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $332.88	Facility		$112.20	$112.20	$332.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $332.88 / $582.88	Professional		$112.20	$332.88	$582.88
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 $216.48 / $273.73 / $456.21	Professional		$216.48	$273.73	$456.21