Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $326.05 / $326.05 / $326.05	Facility		$326.05	$326.05	$326.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.62 / $326.05 / $326.05	Professional		$252.62	$326.05	$326.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $864.14 / $1,721.70 / $3,135.78	Facility		$864.14	$1,721.70	$3,135.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $542.38 / $570.92 / $770.76	Professional		$542.38	$570.92	$770.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $319.38 / $334.86 / $371.10	Facility		$319.38	$334.86	$371.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $456.74 / $456.74 / $456.74	Professional		$456.74	$456.74	$456.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $305.54 / $305.54 / $305.54	Facility		$305.54	$305.54	$305.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.54 / $305.54 / $661.88	Professional		$305.54	$305.54	$661.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $326.05 / $412.59 / $412.59	Facility		$326.05	$412.59	$412.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $326.05 / $412.59 / $642.15	Professional		$326.05	$412.59	$642.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $175.35	Professional		$30.00	$30.00	$175.35
United Facility/Professional Facility Modifier Low / Median / High Price $244.40 / $244.40 / $244.40	Facility		$244.40	$244.40	$244.40
United Facility/Professional Professional Modifier Low / Median / High Price $203.29 / $272.95 / $381.50	Professional		$203.29	$272.95	$381.50