Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.10 / $645.10 / $1,006.36	Facility		$645.10	$645.10	$1,006.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $479.76 / $858.75 / $1,139.97	Professional		$479.76	$858.75	$1,139.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,019.43 / $1,461.66 / $2,590.52	Facility		$1,019.43	$1,461.66	$2,590.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $929.06 / $977.96 / $1,046.42	Professional		$929.06	$977.96	$1,046.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $977.96 / $1,356.11 / $2,281.91	Facility		$977.96	$1,356.11	$2,281.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $847.57 / $1,369.15 / $1,760.33	Professional		$847.57	$1,369.15	$1,760.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.38 / $838.33 / $1,872.96	Professional		$441.38	$838.33	$1,872.96
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $645.10 / $645.10 / $1,185.36	Facility		$645.10	$645.10	$1,185.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $645.10 / $876.34 / $1,564.74	Professional		$645.10	$876.34	$1,564.74
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 $679.05 / $679.05 / $1,117.78	Facility		$679.05	$679.05	$1,117.78
United Facility/Professional Professional Modifier Low / Median / High Price $285.20 / $547.66 / $882.77	Professional		$285.20	$547.66	$882.77