Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.20 / $209.20 / $209.20	Facility		$209.20	$209.20	$209.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.87 / $209.20 / $237.39	Professional		$178.87	$209.20	$237.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $366.32 / $366.32 / $366.32	Facility		$366.32	$366.32	$366.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.00 / $366.32 / $494.53	Professional		$348.00	$366.32	$494.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $238.11 / $244.73 / $256.89	Facility		$238.11	$244.73	$256.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $293.06 / $293.06 / $293.06	Professional		$293.06	$293.06	$293.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.90 / $228.90 / $228.90	Facility		$228.90	$228.90	$228.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.63 / $228.90 / $424.50	Professional		$220.63	$228.90	$424.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $209.20 / $264.72 / $264.72	Facility		$209.20	$264.72	$264.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $209.20 / $264.72 / $412.02	Professional		$209.20	$264.72	$412.02
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 $152.30 / $182.35 / $281.62	Professional		$152.30	$182.35	$281.62