Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.73 / $198.73 / $198.73	Facility		$198.73	$198.73	$198.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.15 / $198.73 / $198.73	Professional		$155.15	$198.73	$198.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $526.69 / $1,049.36 / $1,911.25	Facility		$526.69	$1,049.36	$1,911.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.58 / $347.98 / $469.77	Professional		$330.58	$347.98	$469.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.64 / $208.76 / $226.19	Facility		$169.64	$208.76	$226.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $278.38 / $278.38 / $278.38	Professional		$278.38	$278.38	$278.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.10 / $225.10 / $225.10	Facility		$225.10	$225.10	$225.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.10 / $225.10 / $403.50	Professional		$225.10	$225.10	$403.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $198.73 / $251.47 / $251.47	Facility		$198.73	$251.47	$251.47
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $198.73 / $251.47 / $391.39	Professional		$198.73	$251.47	$391.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $112.14	Professional		$30.00	$30.00	$112.14
United Facility/Professional Facility Modifier Low / Median / High Price $2.15 / $172.06 / $200.64	Facility		$2.15	$172.06	$200.64
United Facility/Professional Professional Modifier Low / Median / High Price $108.51 / $166.36 / $232.51	Professional		$108.51	$166.36	$232.51