Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $270.30 / $270.30 / $270.30	Facility		$270.30	$270.30	$270.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.93 / $270.30 / $270.30	Professional		$209.93	$270.30	$270.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $716.37 / $1,427.28 / $2,599.55	Facility		$716.37	$1,427.28	$2,599.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $449.64 / $473.30 / $638.96	Professional		$449.64	$473.30	$638.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $258.73 / $258.73 / $307.64	Facility		$258.73	$258.73	$307.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $378.64 / $378.64 / $378.64	Professional		$378.64	$378.64	$378.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $306.16 / $306.16 / $306.16	Facility		$306.16	$306.16	$306.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.16 / $306.16 / $548.63	Professional		$306.16	$306.16	$548.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $270.30 / $342.02 / $342.02	Facility		$270.30	$342.02	$342.02
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $267.79 / $342.02 / $496.96	Professional		$267.79	$342.02	$496.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $287.19 / $350.24 / $402.77	Professional		$287.19	$350.24	$402.77
United Facility/Professional Professional Modifier Low / Median / High Price $165.49 / $226.27 / $330.98	Professional		$165.49	$226.27	$330.98