Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.63 / $208.63 / $208.63	Facility		$208.63	$208.63	$208.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.38 / $208.63 / $208.63	Professional		$178.38	$208.63	$208.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $552.94 / $1,101.66 / $2,006.48	Facility		$552.94	$1,101.66	$2,006.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $347.05 / $365.32 / $493.18	Professional		$347.05	$365.32	$493.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $237.46 / $258.58 / $270.20	Facility		$237.46	$258.58	$270.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $292.26 / $292.26 / $292.26	Professional		$292.26	$292.26	$292.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.28 / $228.28 / $228.28	Facility		$228.28	$228.28	$228.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.28 / $228.28 / $423.38	Professional		$228.28	$228.28	$423.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $208.63 / $264.00 / $264.00	Facility		$208.63	$264.00	$264.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $208.63 / $264.00 / $383.58	Professional		$208.63	$264.00	$383.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $221.67 / $270.33 / $310.89	Professional		$221.67	$270.33	$310.89
United Facility/Professional Professional Modifier Low / Median / High Price $155.60 / $181.85 / $280.85	Professional		$155.60	$181.85	$280.85