Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.69 / $214.69 / $214.69	Facility		$214.69	$214.69	$214.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.91 / $214.69 / $216.67	Professional		$178.91	$214.69	$216.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $568.98 / $1,133.61 / $2,064.69	Facility		$568.98	$1,133.61	$2,064.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $357.12 / $375.92 / $507.49	Professional		$357.12	$375.92	$507.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $227.67 / $227.67 / $244.35	Facility		$227.67	$227.67	$244.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $300.74 / $300.74 / $300.74	Professional		$300.74	$300.74	$300.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.19 / $243.19 / $243.19	Facility		$243.19	$243.19	$243.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.19 / $243.19 / $435.75	Professional		$243.19	$243.19	$435.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $214.69 / $271.67 / $271.67	Facility		$214.69	$271.67	$271.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $214.69 / $271.67 / $432.30	Professional		$214.69	$271.67	$432.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $228.10 / $278.18 / $319.90	Professional		$228.10	$278.18	$319.90
United Facility/Professional Professional Modifier Low / Median / High Price $145.62 / $176.54 / $269.27	Professional		$145.62	$176.54	$269.27