Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $307.91 / $307.91 / $1,924.88	Facility		$307.91	$307.91	$1,924.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.26 / $307.91 / $307.91	Professional		$213.26	$307.91	$307.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $539.16 / $539.16 / $539.16	Facility		$539.16	$539.16	$539.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.20 / $539.16 / $727.87	Professional		$512.20	$539.16	$727.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $262.83 / $262.83 / $350.45	Facility		$262.83	$262.83	$350.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $431.33 / $431.33 / $431.33	Professional		$431.33	$431.33	$431.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.68 / $252.68 / $252.68	Facility		$252.68	$252.68	$252.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.10 / $252.68 / $625.13	Professional		$194.10	$252.68	$625.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $307.91 / $389.62 / $1,924.88	Facility		$307.91	$389.62	$1,924.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $307.91 / $389.62 / $606.41	Professional		$307.91	$389.62	$606.41
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 $168.11 / $257.75 / $358.64	Professional		$168.11	$257.75	$358.64