Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.18 / $148.18 / $148.18	Facility		$148.18	$148.18	$148.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.30 / $148.18 / $195.63	Professional		$121.30	$148.18	$195.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $762.66 / $1,519.50 / $2,767.51	Facility		$762.66	$1,519.50	$2,767.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.69 / $503.88 / $680.24	Professional		$478.69	$503.88	$680.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $367.37 / $367.37 / $367.37	Facility		$367.37	$367.37	$367.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $409.07 / $409.07 / $409.07	Facility		$409.07	$409.07	$409.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.71 / $409.07 / $607.88	Professional		$347.71	$409.07	$607.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $148.18 / $458.35 / $458.35	Facility		$148.18	$458.35	$458.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $148.18 / $428.56 / $503.88	Professional		$148.18	$428.56	$503.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Facility Modifier Low / Median / High Price $318.88 / $318.88 / $318.88	Facility		$318.88	$318.88	$318.88
United Facility/Professional Professional Modifier Low / Median / High Price $144.36 / $286.00 / $441.54	Professional		$144.36	$286.00	$441.54