Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.33 / $322.33 / $322.33	Facility		$322.33	$322.33	$322.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.83 / $322.33 / $322.33	Professional		$263.83	$322.33	$322.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $854.29 / $1,702.06 / $3,100.02	Facility		$854.29	$1,702.06	$3,100.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $536.20 / $564.41 / $761.97	Professional		$536.20	$564.41	$761.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $313.30 / $357.19 / $366.87	Facility		$313.30	$357.19	$366.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $451.54 / $451.54 / $451.54	Professional		$451.54	$451.54	$451.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $365.10 / $365.10 / $365.10	Facility		$365.10	$365.10	$365.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.10 / $365.10 / $654.38	Professional		$365.10	$365.10	$654.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $322.33 / $407.86 / $407.86	Facility		$322.33	$407.86	$407.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $322.33 / $407.86 / $634.82	Professional		$322.33	$407.86	$634.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $230.46	Professional		$30.00	$30.00	$230.46
United Facility/Professional Professional Modifier Low / Median / High Price $200.39 / $269.82 / $391.21	Professional		$200.39	$269.82	$391.21