Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.44 / $234.44 / $234.44	Facility		$234.44	$234.44	$234.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.60 / $234.44 / $234.44	Professional		$164.60	$234.44	$234.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $621.32 / $1,237.90 / $2,254.63	Facility		$621.32	$1,237.90	$2,254.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.97 / $410.50 / $554.17	Professional		$389.97	$410.50	$554.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $200.12 / $202.86 / $266.83	Facility		$200.12	$202.86	$266.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $328.40 / $328.40 / $328.40	Professional		$328.40	$328.40	$328.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.56 / $265.56 / $265.56	Facility		$265.56	$265.56	$265.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.56 / $265.56 / $475.88	Professional		$265.56	$265.56	$475.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $234.44 / $296.64 / $296.64	Facility		$234.44	$296.64	$296.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $230.15 / $296.64 / $431.02	Professional		$230.15	$296.64	$431.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $249.09 / $303.77 / $349.33	Professional		$249.09	$303.77	$349.33
United Facility/Professional Professional Modifier Low / Median / High Price $128.00 / $196.25 / $274.29	Professional		$128.00	$196.25	$274.29