Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.51 / $204.51 / $204.51	Facility		$204.51	$204.51	$204.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.43 / $204.51 / $204.51	Professional		$170.43	$204.51	$204.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $542.01 / $1,079.89 / $1,966.83	Facility		$542.01	$1,079.89	$1,966.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.20 / $358.10 / $483.44	Professional		$340.20	$358.10	$483.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $227.19 / $232.77 / $234.07	Facility		$227.19	$232.77	$234.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $286.48 / $286.48 / $286.48	Professional		$286.48	$286.48	$286.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.66 / $231.66 / $231.66	Facility		$231.66	$231.66	$231.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.93 / $231.66 / $415.13	Professional		$180.93	$231.66	$415.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $204.51 / $258.77 / $258.77	Facility		$204.51	$258.77	$258.77
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $204.51 / $258.77 / $376.00	Professional		$204.51	$258.77	$376.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $225.24 / $264.99 / $304.73	Professional		$225.24	$264.99	$304.73
United Facility/Professional Professional Modifier Low / Median / High Price $133.01 / $171.19 / $256.30	Professional		$133.01	$171.19	$256.30