Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $196.97 / $196.97 / $196.97	Facility		$196.97	$196.97	$196.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.43 / $196.97 / $196.97	Professional		$136.43	$196.97	$196.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $522.03 / $1,040.08 / $1,894.33	Facility		$522.03	$1,040.08	$1,894.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.66 / $344.90 / $465.62	Professional		$327.66	$344.90	$465.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $168.14 / $168.14 / $224.19	Facility		$168.14	$168.14	$224.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.92 / $275.92 / $275.92	Professional		$275.92	$275.92	$275.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.63 / $161.63 / $161.63	Facility		$161.63	$161.63	$161.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $161.63 / $399.75	Professional		$161.63	$161.63	$399.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $196.97 / $249.24 / $249.24	Facility		$196.97	$249.24	$249.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $175.63 / $249.24 / $362.14	Professional		$175.63	$249.24	$362.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $209.28 / $255.23 / $293.51	Professional		$209.28	$255.23	$293.51
United Facility/Professional Facility Modifier Low / Median / High Price $2.13 / $170.54 / $198.86	Facility		$2.13	$170.54	$198.86
United Facility/Professional Professional Modifier Low / Median / High Price $107.54 / $164.89 / $229.42	Professional		$107.54	$164.89	$229.42