Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.16 / $195.16 / $195.16	Facility		$195.16	$195.16	$195.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.26 / $195.16 / $195.16	Professional		$165.26	$195.16	$195.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $517.23 / $1,030.52 / $1,876.92	Facility		$517.23	$1,030.52	$1,876.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $324.64 / $341.73 / $461.34	Professional		$324.64	$341.73	$461.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $219.06 / $219.26 / $222.12	Facility		$219.06	$219.26	$222.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $273.38 / $273.38 / $273.38	Professional		$273.38	$273.38	$273.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $221.07 / $221.07 / $221.07	Facility		$221.07	$221.07	$221.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.07 / $221.07 / $396.00	Professional		$221.07	$221.07	$396.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $195.16 / $246.96 / $246.96	Facility		$195.16	$246.96	$246.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $184.15 / $246.96 / $358.81	Professional		$184.15	$246.96	$358.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $207.36 / $252.88 / $290.81	Professional		$207.36	$252.88	$290.81
United Facility/Professional Professional Modifier Low / Median / High Price $132.36 / $163.37 / $244.74	Professional		$132.36	$163.37	$244.74