Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.54 / $214.54 / $214.54	Facility		$214.54	$214.54	$214.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.79 / $214.54 / $214.54	Professional		$178.79	$214.54	$214.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $375.67 / $375.67 / $375.67	Facility		$375.67	$375.67	$375.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $356.89 / $375.67 / $507.15	Professional		$356.89	$375.67	$507.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.18 / $244.19 / $255.00	Facility		$234.18	$244.19	$255.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $300.54 / $300.54 / $300.54	Professional		$300.54	$300.54	$300.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.83 / $302.83 / $302.83	Facility		$302.83	$302.83	$302.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.41 / $302.83 / $435.38	Professional		$257.41	$302.83	$435.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $214.54 / $271.48 / $271.48	Facility		$214.54	$271.48	$271.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $214.54 / $271.48 / $432.47	Professional		$214.54	$271.48	$432.47
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 Facility Modifier Low / Median / High Price $2.81 / $224.66 / $256.16	Facility		$2.81	$224.66	$256.16
United Facility/Professional Professional Modifier Low / Median / High Price $141.68 / $179.60 / $268.88	Professional		$141.68	$179.60	$268.88