Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.90 / $253.90 / $253.90	Facility		$253.90	$253.90	$253.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.59 / $253.90 / $253.90	Professional		$211.59	$253.90	$253.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $672.91 / $1,340.71 / $2,441.87	Facility		$672.91	$1,340.71	$2,441.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $422.36 / $444.59 / $600.20	Professional		$422.36	$444.59	$600.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $282.04 / $288.98 / $290.55	Facility		$282.04	$288.98	$290.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $355.67 / $355.67 / $355.67	Professional		$355.67	$355.67	$355.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.80 / $286.80 / $286.80	Facility		$286.80	$286.80	$286.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.36 / $369.67 / $644.05	Professional		$209.36	$369.67	$644.05
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $253.90 / $321.27 / $321.27	Facility		$253.90	$321.27	$321.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $253.90 / $321.27 / $500.05	Professional		$253.90	$321.27	$500.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $279.64 / $329.00 / $378.35	Professional		$279.64	$329.00	$378.35
United Facility/Professional Professional Modifier Low / Median / High Price $169.27 / $211.06 / $318.19	Professional		$169.27	$211.06	$318.19