Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.25 / $199.25 / $199.25	Facility		$199.25	$199.25	$199.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.43 / $199.25 / $199.25	Professional		$158.43	$199.25	$199.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $528.07 / $1,052.10 / $1,916.24	Facility		$528.07	$1,052.10	$1,916.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.45 / $348.89 / $471.00	Professional		$331.45	$348.89	$471.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $195.47 / $210.01 / $226.78	Facility		$195.47	$210.01	$226.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $279.11 / $279.11 / $279.11	Professional		$279.11	$279.11	$279.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.68 / $225.68 / $225.68	Facility		$225.68	$225.68	$225.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.68 / $225.68 / $404.63	Professional		$225.68	$225.68	$404.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $199.25 / $252.13 / $252.13	Facility		$199.25	$252.13	$252.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $199.25 / $252.13 / $392.42	Professional		$199.25	$252.13	$392.42
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 Professional Modifier Low / Median / High Price $125.02 / $166.79 / $244.06	Professional		$125.02	$166.79	$244.06