Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.41 / $264.41 / $264.41	Facility		$264.41	$264.41	$264.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.85 / $264.41 / $264.41	Professional		$211.85	$264.41	$264.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $700.78 / $1,396.22 / $2,542.98	Facility		$700.78	$1,396.22	$2,542.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $439.85 / $463.00 / $625.04	Professional		$439.85	$463.00	$625.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $265.43 / $280.83 / $300.95	Facility		$265.43	$280.83	$300.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $370.40 / $370.40 / $370.40	Professional		$370.40	$370.40	$370.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $299.52 / $299.52 / $299.52	Facility		$299.52	$299.52	$299.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.52 / $299.52 / $536.63	Professional		$299.52	$299.52	$536.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $264.41 / $334.58 / $334.58	Facility		$264.41	$334.58	$334.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $261.97 / $334.58 / $497.28	Professional		$261.97	$334.58	$497.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $280.94 / $342.62 / $394.01	Professional		$280.94	$342.62	$394.01
United Facility/Professional Facility Modifier Low / Median / High Price $462.82 / $544.49 / $544.49	Facility		$462.82	$544.49	$544.49
United Facility/Professional Professional Modifier Low / Median / High Price $169.78 / $221.35 / $331.38	Professional		$169.78	$221.35	$331.38