Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.36 / $128.36 / $128.36	Facility		$128.36	$128.36	$128.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.08 / $128.36 / $300.97	Professional		$105.08	$128.36	$300.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.46 / $1,330.75 / $2,423.73	Facility		$645.46	$1,330.75	$2,423.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.27 / $441.29 / $565.96	Professional		$398.27	$441.29	$565.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.66 / $65.66 / $65.66	Facility		$65.66	$65.66	$65.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $598.91 / $598.91 / $598.91	Professional		$598.91	$598.91	$598.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.61 / $482.61 / $482.61	Facility		$482.61	$482.61	$482.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $410.22 / $482.61 / $482.61	Professional		$410.22	$482.61	$482.61
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $128.36 / $411.52 / $411.52	Facility		$128.36	$411.52	$411.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.36 / $401.57 / $473.24	Professional		$128.36	$401.57	$473.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $125.05 / $248.12 / $406.72	Professional		$125.05	$248.12	$406.72