Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $642.67 / $642.67 / $1,002.58	Facility		$642.67	$642.67	$1,002.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $581.79 / $642.67 / $642.67	Professional		$581.79	$642.67	$642.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $548.78 / $765.23 / $1,344.00	Facility		$548.78	$765.23	$1,344.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $482.01 / $507.38 / $542.90	Professional		$482.01	$507.38	$542.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $676.50 / $1,004.78 / $1,623.60	Facility		$676.50	$1,004.78	$1,623.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $676.50 / $845.63 / $913.28	Professional		$676.50	$845.63	$913.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $282.88 / $941.01	Professional		$113.15	$282.88	$941.01
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $271.56 / $642.67 / $1,180.92	Facility		$271.56	$642.67	$1,180.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $271.56 / $302.68 / $811.80	Professional		$271.56	$302.68	$811.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $560.14 / $616.15 / $1,008.25	Professional		$560.14	$616.15	$1,008.25
United Facility/Professional Professional Modifier Low / Median / High Price $118.81 / $169.73 / $284.13	Professional		$118.81	$169.73	$284.13