Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $329.80 / $329.80 / $329.80	Facility		$329.80	$329.80	$329.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $274.14 / $329.80 / $329.80	Professional		$274.14	$329.80	$329.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $874.08 / $1,741.51 / $3,171.86	Facility		$874.08	$1,741.51	$3,171.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $548.63 / $577.50 / $779.63	Professional		$548.63	$577.50	$779.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $369.99 / $375.38 / $427.39	Facility		$369.99	$375.38	$427.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $462.00 / $462.00 / $462.00	Professional		$462.00	$462.00	$462.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.57 / $373.57 / $373.57	Facility		$373.57	$373.57	$373.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.76 / $373.57 / $480.18	Professional		$326.76	$373.57	$480.18
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $329.80 / $417.33 / $417.33	Facility		$329.80	$417.33	$417.33
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $329.80 / $417.33 / $649.54	Professional		$329.80	$417.33	$649.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $350.42 / $427.35 / $491.45	Professional		$350.42	$427.35	$491.45
United Facility/Professional Facility Modifier Low / Median / High Price $4.61 / $276.36 / $364.85	Facility		$4.61	$276.36	$364.85
United Facility/Professional Professional Modifier Low / Median / High Price $218.34 / $276.08 / $426.71	Professional		$218.34	$276.08	$426.71