Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.69 / $194.69 / $194.69	Facility		$194.69	$194.69	$194.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.16 / $194.69 / $194.69	Professional		$163.16	$194.69	$194.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $515.99 / $1,028.05 / $1,872.41	Facility		$515.99	$1,028.05	$1,872.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.86 / $340.91 / $460.23	Professional		$323.86	$340.91	$460.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $216.28 / $221.59 / $222.77	Facility		$216.28	$221.59	$222.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $272.73 / $272.73 / $272.73	Professional		$272.73	$272.73	$272.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $220.51 / $220.51 / $220.51	Facility		$220.51	$220.51	$220.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.51 / $220.51 / $395.25	Professional		$220.51	$220.51	$395.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $194.69 / $246.34 / $246.34	Facility		$194.69	$246.34	$246.34
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $194.69 / $246.34 / $357.95	Professional		$194.69	$246.34	$357.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $206.86 / $252.27 / $290.11	Professional		$206.86	$252.27	$290.11
United Facility/Professional Professional Modifier Low / Median / High Price $127.42 / $162.97 / $242.50	Professional		$127.42	$162.97	$242.50