Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $437.57 / $437.57 / $437.57	Facility		$437.57	$437.57	$437.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.39 / $437.57 / $437.57	Professional		$328.39	$437.57	$437.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,159.71 / $2,310.58 / $4,208.33	Facility		$1,159.71	$2,310.58	$4,208.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $727.90 / $766.21 / $1,034.38	Professional		$727.90	$766.21	$1,034.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $435.31 / $447.28 / $498.04	Facility		$435.31	$447.28	$498.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $612.97 / $612.97 / $612.97	Professional		$612.97	$612.97	$612.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.47 / $528.47 / $528.47	Facility		$528.47	$528.47	$528.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $528.47 / $528.47 / $888.38	Professional		$528.47	$528.47	$888.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $437.57 / $553.69 / $553.69	Facility		$437.57	$553.69	$553.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $437.57 / $553.69 / $861.79	Professional		$437.57	$553.69	$861.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $464.94 / $567.00 / $652.04	Professional		$464.94	$567.00	$652.04
United Facility/Professional Professional Modifier Low / Median / High Price $264.33 / $366.29 / $511.95	Professional		$264.33	$366.29	$511.95