Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.36 / $230.36 / $230.36	Facility		$230.36	$230.36	$230.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.97 / $230.36 / $230.36	Professional		$191.97	$230.36	$230.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $610.51 / $1,216.36 / $2,215.41	Facility		$610.51	$1,216.36	$2,215.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $383.19 / $403.36 / $544.54	Professional		$383.19	$403.36	$544.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $233.53 / $246.86 / $262.18	Facility		$233.53	$246.86	$262.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $322.69 / $322.69 / $322.69	Professional		$322.69	$322.69	$322.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $271.68 / $271.68 / $271.68	Facility		$271.68	$271.68	$271.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.68 / $271.68 / $467.63	Professional		$271.68	$271.68	$467.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $230.36 / $291.48 / $291.48	Facility		$230.36	$291.48	$291.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $218.75 / $291.48 / $423.52	Professional		$218.75	$291.48	$423.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $244.76 / $298.49 / $343.26	Professional		$244.76	$298.49	$343.26
United Facility/Professional Professional Modifier Low / Median / High Price $140.34 / $192.83 / $280.67	Professional		$140.34	$192.83	$280.67