Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.39 / $248.39 / $248.39	Facility		$248.39	$248.39	$248.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.37 / $248.39 / $276.89	Professional		$212.37	$248.39	$276.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $658.31 / $1,311.61 / $2,388.86	Facility		$658.31	$1,311.61	$2,388.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $413.19 / $434.94 / $587.16	Professional		$413.19	$434.94	$587.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $282.70 / $282.70 / $282.70	Facility		$282.70	$282.70	$282.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $347.95 / $347.95 / $347.95	Professional		$347.95	$347.95	$347.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $271.77 / $271.77 / $271.77	Facility		$271.77	$271.77	$271.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.77 / $271.77 / $504.38	Professional		$271.77	$271.77	$504.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $248.39 / $314.31 / $314.31	Facility		$248.39	$314.31	$314.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $248.39 / $314.31 / $456.68	Professional		$248.39	$314.31	$456.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $263.92 / $321.86 / $370.13	Professional		$263.92	$321.86	$370.13
United Facility/Professional Professional Modifier Low / Median / High Price $180.82 / $216.98 / $334.37	Professional		$180.82	$216.98	$334.37