Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $300.14 / $300.14 / $300.14	Facility		$300.14	$300.14	$300.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.44 / $300.14 / $300.14	Professional		$255.44	$300.14	$300.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.97 / $188.75 / $265.48	Facility		$159.97	$188.75	$265.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.47 / $217.09 / $416.82	Professional		$69.47	$217.09	$416.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $341.63 / $341.63 / $342.15	Facility		$341.63	$341.63	$342.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $420.46 / $420.46 / $420.46	Professional		$420.46	$420.46	$420.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $420.61 / $420.61 / $420.61	Facility		$420.61	$420.61	$420.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $357.52 / $420.61 / $609.38	Professional		$357.52	$420.61	$609.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $300.14 / $379.81 / $379.81	Facility		$300.14	$379.81	$379.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $300.14 / $379.81 / $604.41	Professional		$300.14	$379.81	$604.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $192.20	Professional		$30.00	$30.00	$192.20
United Facility/Professional Professional Modifier Low / Median / High Price $196.77 / $251.26 / $374.48	Professional		$196.77	$251.26	$374.48