Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $402.90 / $402.90 / $402.90	Facility		$402.90	$402.90	$402.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.89 / $402.90 / $402.90	Professional		$342.89	$402.90	$402.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,067.81 / $2,127.48 / $3,874.83	Facility		$1,067.81	$2,127.48	$3,874.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $670.22 / $705.49 / $952.41	Professional		$670.22	$705.49	$952.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $458.57 / $458.57 / $494.97	Facility		$458.57	$458.57	$494.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $564.39 / $564.39 / $564.39	Professional		$564.39	$564.39	$564.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $448.56 / $448.56 / $448.56	Facility		$448.56	$448.56	$448.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $448.56 / $448.56 / $817.88	Professional		$448.56	$448.56	$817.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $402.90 / $509.82 / $509.82	Facility		$402.90	$509.82	$509.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $376.04 / $509.82 / $793.50	Professional		$376.04	$509.82	$793.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $428.08 / $522.05 / $600.36	Professional		$428.08	$522.05	$600.36
United Facility/Professional Facility Modifier Low / Median / High Price $470.15 / $470.15 / $470.15	Facility		$470.15	$470.15	$470.15
United Facility/Professional Professional Modifier Low / Median / High Price $293.30 / $351.96 / $542.36	Professional		$293.30	$351.96	$542.36