Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $272.27 / $272.27 / $272.27	Facility		$272.27	$272.27	$272.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.32 / $272.27 / $272.27	Professional		$215.32	$272.27	$272.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $721.59 / $1,437.69 / $2,618.50	Facility		$721.59	$1,437.69	$2,618.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $452.91 / $476.75 / $643.61	Professional		$452.91	$476.75	$643.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $264.07 / $309.89 / $325.10	Facility		$264.07	$309.89	$325.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $381.40 / $381.40 / $381.40	Professional		$381.40	$381.40	$381.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $280.67 / $280.67 / $280.67	Facility		$280.67	$280.67	$280.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.67 / $280.67 / $552.75	Professional		$280.67	$280.67	$552.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $272.27 / $344.52 / $344.52	Facility		$272.27	$344.52	$344.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $266.67 / $344.52 / $500.58	Professional		$266.67	$344.52	$500.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $289.29 / $352.80 / $405.72	Professional		$289.29	$352.80	$405.72
United Facility/Professional Professional Modifier Low / Median / High Price $168.90 / $227.92 / $337.80	Professional		$168.90	$227.92	$337.80