Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $285.70 / $285.70 / $285.70	Facility		$285.70	$285.70	$285.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.92 / $285.70 / $285.70	Professional		$241.92	$285.70	$285.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $757.21 / $1,508.64 / $2,747.74	Facility		$757.21	$1,508.64	$2,747.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $475.27 / $500.28 / $675.38	Professional		$475.27	$500.28	$675.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $298.92 / $301.70 / $325.18	Facility		$298.92	$301.70	$325.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $400.22 / $400.22 / $400.22	Professional		$400.22	$400.22	$400.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $352.55 / $352.55 / $352.55	Facility		$352.55	$352.55	$352.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.55 / $352.55 / $580.13	Professional		$352.55	$352.55	$580.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $285.70 / $361.52 / $361.52	Facility		$285.70	$361.52	$361.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $285.70 / $361.52 / $562.67	Professional		$285.70	$361.52	$562.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $219.88	Professional		$30.00	$30.00	$219.88
United Facility/Professional Professional Modifier Low / Median / High Price $179.64 / $234.94 / $358.07	Professional		$179.64	$234.94	$358.07