Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.22 / $174.22 / $174.22	Facility		$174.22	$174.22	$174.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.19 / $174.22 / $174.22	Professional		$145.19	$174.22	$174.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $461.74 / $919.97 / $1,675.57	Facility		$461.74	$919.97	$1,675.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.82 / $305.07 / $411.84	Professional		$289.82	$305.07	$411.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $193.53 / $198.30 / $199.37	Facility		$193.53	$198.30	$199.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $244.06 / $244.06 / $244.06	Professional		$244.06	$244.06	$244.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.29 / $170.29 / $170.29	Facility		$170.29	$170.29	$170.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.29 / $170.29 / $353.63	Professional		$170.29	$170.29	$353.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $174.22 / $220.47 / $220.47	Facility		$174.22	$220.47	$220.47
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $174.22 / $220.47 / $343.13	Professional		$174.22	$220.47	$343.13
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 $113.30 / $145.85 / $215.61	Professional		$113.30	$145.85	$215.61