Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $268.42 / $268.42 / $268.42	Facility		$268.42	$268.42	$268.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.69 / $268.42 / $268.42	Professional		$223.69	$268.42	$268.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $711.41 / $1,417.39 / $2,581.54	Facility		$711.41	$1,417.39	$2,581.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.52 / $470.02 / $634.53	Professional		$446.52	$470.02	$634.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $298.17 / $305.51 / $307.14	Facility		$298.17	$305.51	$307.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $376.02 / $376.02 / $376.02	Professional		$376.02	$376.02	$376.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $294.27 / $294.27 / $294.27	Facility		$294.27	$294.27	$294.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.27 / $294.27 / $544.88	Professional		$294.27	$294.27	$544.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $268.42 / $339.65 / $339.65	Facility		$268.42	$339.65	$339.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $268.42 / $339.65 / $528.65	Professional		$268.42	$339.65	$528.65
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 $3.46 / $276.79 / $315.60	Facility		$3.46	$276.79	$315.60
United Facility/Professional Professional Modifier Low / Median / High Price $174.55 / $224.69 / $336.39	Professional		$174.55	$224.69	$336.39