Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.97 / $240.97 / $240.97	Facility		$240.97	$240.97	$240.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.81 / $240.97 / $245.38	Professional		$200.81	$240.97	$245.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $638.65 / $1,272.43 / $2,317.52	Facility		$638.65	$1,272.43	$2,317.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.85 / $421.95 / $569.63	Professional		$400.85	$421.95	$569.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $252.62 / $257.27 / $274.27	Facility		$252.62	$257.27	$274.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $337.56 / $337.56 / $337.56	Professional		$337.56	$337.56	$337.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $277.45 / $277.45 / $277.45	Facility		$277.45	$277.45	$277.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.45 / $277.45 / $489.00	Professional		$277.45	$277.45	$489.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $240.97 / $304.92 / $304.92	Facility		$240.97	$304.92	$304.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $240.97 / $304.92 / $450.00	Professional		$240.97	$304.92	$450.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $157.43 / $201.72 / $339.62	Professional		$157.43	$201.72	$339.62