Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.36 / $242.36 / $569.32	Facility		$242.36	$242.36	$569.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.22 / $242.36 / $268.49	Professional		$207.22	$242.36	$268.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $642.34 / $1,279.79 / $2,330.92	Facility		$642.34	$1,279.79	$2,330.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $403.17 / $424.39 / $572.92	Professional		$403.17	$424.39	$572.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $270.29 / $275.85 / $340.44	Facility		$270.29	$275.85	$340.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $339.51 / $339.51 / $339.51	Professional		$339.51	$339.51	$339.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $274.52 / $274.52 / $274.52	Facility		$274.52	$274.52	$274.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.52 / $274.52 / $492.00	Professional		$274.52	$274.52	$492.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $242.36 / $306.68 / $569.32	Facility		$242.36	$306.68	$569.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $242.36 / $306.68 / $469.15	Professional		$242.36	$306.68	$469.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $257.52 / $314.05 / $361.15	Professional		$257.52	$314.05	$361.15
United Facility/Professional Professional Modifier Low / Median / High Price $172.25 / $206.69 / $318.51	Professional		$172.25	$206.69	$318.51