Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $352.55 / $352.55 / $352.55	Facility		$352.55	$352.55	$352.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.83 / $352.55 / $352.55	Professional		$292.83	$352.55	$352.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $934.38 / $1,861.65 / $3,390.68	Facility		$934.38	$1,861.65	$3,390.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $586.47 / $617.34 / $833.41	Professional		$586.47	$617.34	$833.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $310.88 / $388.18 / $401.27	Facility		$310.88	$388.18	$401.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $493.87 / $493.87 / $493.87	Professional		$493.87	$493.87	$493.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $298.85 / $298.85 / $298.85	Facility		$298.85	$298.85	$298.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.85 / $298.85 / $715.50	Professional		$298.85	$298.85	$715.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $352.55 / $446.11 / $446.11	Facility		$352.55	$446.11	$446.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $352.55 / $446.11 / $694.35	Professional		$352.55	$446.11	$694.35
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 $205.32 / $295.12 / $410.64	Professional		$205.32	$295.12	$410.64