Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.00 / $741.00 / $1,155.96	Facility		$741.00	$741.00	$1,155.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $670.80 / $741.00 / $741.00	Professional		$670.80	$741.00	$741.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $632.74 / $882.30 / $1,549.61	Facility		$632.74	$882.30	$1,549.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $555.75 / $585.00 / $625.95	Professional		$555.75	$585.00	$625.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $780.00 / $1,158.50 / $1,906.24	Facility		$780.00	$1,158.50	$1,906.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $780.00 / $975.00 / $1,053.00	Professional		$780.00	$975.00	$1,053.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $312.00 / $390.00 / $1,755.00	Professional		$312.00	$390.00	$1,755.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $360.09 / $741.00 / $1,361.59	Facility		$360.09	$741.00	$1,361.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $360.09 / $486.12 / $936.00	Professional		$360.09	$486.12	$936.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $645.84 / $710.42 / $871.88	Professional		$645.84	$710.42	$871.88
United Facility/Professional Professional Modifier Low / Median / High Price $327.60 / $468.00 / $780.00	Professional		$327.60	$468.00	$780.00