Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $246.13 / $246.13 / $246.13	Facility		$246.13	$246.13	$246.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.52 / $246.13 / $246.13	Professional		$204.52	$246.13	$246.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $652.30 / $1,299.66 / $2,367.11	Facility		$652.30	$1,299.66	$2,367.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $409.43 / $430.98 / $581.82	Professional		$409.43	$430.98	$581.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $232.64 / $280.14 / $294.79	Facility		$232.64	$280.14	$294.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $344.78 / $344.78 / $344.78	Professional		$344.78	$344.78	$344.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.81 / $297.81 / $297.81	Facility		$297.81	$297.81	$297.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.81 / $297.81 / $499.50	Professional		$297.81	$297.81	$499.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $246.13 / $311.44 / $311.44	Facility		$246.13	$311.44	$311.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $241.60 / $311.44 / $452.52	Professional		$241.60	$311.44	$452.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $261.52 / $318.93 / $366.76	Professional		$261.52	$318.93	$366.76
United Facility/Professional Professional Modifier Low / Median / High Price $161.38 / $206.03 / $304.60	Professional		$161.38	$206.03	$304.60