Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $278.70 / $278.70 / $278.70	Facility		$278.70	$278.70	$278.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.30 / $278.70 / $285.60	Professional		$238.30	$278.70	$285.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $738.68 / $1,471.73 / $2,680.51	Facility		$738.68	$1,471.73	$2,680.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $463.64 / $488.04 / $658.85	Professional		$463.64	$488.04	$658.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $293.08 / $317.23 / $323.27	Facility		$293.08	$317.23	$323.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $390.43 / $390.43 / $390.43	Professional		$390.43	$390.43	$390.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $315.70 / $315.70 / $315.70	Facility		$315.70	$315.70	$315.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.70 / $315.70 / $565.88	Professional		$315.70	$315.70	$565.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $278.70 / $352.68 / $352.68	Facility		$278.70	$352.68	$352.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $278.70 / $352.68 / $548.91	Professional		$278.70	$352.68	$548.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $184.56	Professional		$30.00	$30.00	$184.56
United Facility/Professional Professional Modifier Low / Median / High Price $183.23 / $233.31 / $349.30	Professional		$183.23	$233.31	$349.30