Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $303.88 / $303.88 / $303.88	Facility		$303.88	$303.88	$303.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.82 / $303.88 / $310.33	Professional		$259.82	$303.88	$310.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $805.38 / $1,604.63 / $2,922.56	Facility		$805.38	$1,604.63	$2,922.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $505.50 / $532.11 / $718.35	Professional		$505.50	$532.11	$718.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $325.95 / $345.87 / $411.37	Facility		$325.95	$345.87	$411.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $425.69 / $425.69 / $425.69	Professional		$425.69	$425.69	$425.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $344.22 / $344.22 / $344.22	Facility		$344.22	$344.22	$344.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.22 / $344.22 / $616.88	Professional		$344.22	$344.22	$616.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $303.88 / $384.53 / $384.53	Facility		$303.88	$384.53	$384.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $303.88 / $384.53 / $598.48	Professional		$303.88	$384.53	$598.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $179.84	Professional		$30.00	$30.00	$179.84
United Facility/Professional Professional Modifier Low / Median / High Price $208.49 / $254.38 / $385.52	Professional		$208.49	$254.38	$385.52