Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.85 / $288.85 / $288.85	Facility		$288.85	$288.85	$288.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.87 / $288.85 / $288.85	Professional		$220.87	$288.85	$288.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $765.54 / $1,525.26 / $2,778.00	Facility		$765.54	$1,525.26	$2,778.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $480.50 / $505.79 / $682.82	Professional		$480.50	$505.79	$682.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $272.20 / $272.20 / $328.76	Facility		$272.20	$272.20	$328.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $404.63 / $404.63 / $404.63	Professional		$404.63	$404.63	$404.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $327.20 / $327.20 / $327.20	Facility		$327.20	$327.20	$327.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.20 / $327.20 / $586.50	Professional		$327.20	$327.20	$586.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $288.85 / $365.52 / $365.52	Facility		$288.85	$365.52	$365.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $288.85 / $365.52 / $568.89	Professional		$288.85	$365.52	$568.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Facility Modifier Low / Median / High Price $3.45 / $276.08 / $314.79	Facility		$3.45	$276.08	$314.79
United Facility/Professional Professional Modifier Low / Median / High Price $174.11 / $241.81 / $352.50	Professional		$174.11	$241.81	$352.50