Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.05 / $211.05 / $211.05	Facility		$211.05	$211.05	$211.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.92 / $211.05 / $239.49	Professional		$190.92	$211.05	$239.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $559.34 / $1,114.41 / $2,029.72	Facility		$559.34	$1,114.41	$2,029.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $351.07 / $369.55 / $498.89	Professional		$351.07	$369.55	$498.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $240.21 / $240.21 / $240.21	Facility		$240.21	$240.21	$240.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.64 / $295.64 / $295.64	Professional		$295.64	$295.64	$295.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $230.92 / $230.92 / $230.92	Facility		$230.92	$230.92	$230.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.10 / $230.92 / $307.27	Professional		$209.10	$230.92	$307.27
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $211.05 / $267.05 / $267.05	Facility		$211.05	$267.05	$267.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $211.05 / $267.05 / $388.02	Professional		$211.05	$267.05	$388.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $224.24 / $273.47 / $314.49	Professional		$224.24	$273.47	$314.49
United Facility/Professional Professional Modifier Low / Median / High Price $144.36 / $182.72 / $264.50	Professional		$144.36	$182.72	$264.50