Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $637.12 / $637.12 / $637.12	Facility		$637.12	$637.12	$637.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.95 / $637.12 / $637.12	Professional		$389.95	$637.12	$637.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.65 / $1,454.66 / $3,530.29	Facility		$142.65	$1,454.66	$3,530.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.99 / $728.48 / $1,035.21	Professional		$58.99	$728.48	$1,035.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.39 / $48.70 / $657.51	Facility		$47.39	$48.70	$657.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $58.42 / $876.36	Professional		$58.42	$58.42	$876.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $356.59 / $356.59 / $356.59	Facility		$356.59	$356.59	$356.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.79 / $356.59 / $863.42	Professional		$64.79	$356.59	$863.42
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $634.99 / $634.99 / $637.12	Facility		$634.99	$634.99	$637.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $170.68 / $634.99 / $781.53	Professional		$170.68	$634.99	$781.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.08 / $401.49 / $863.42	Professional		$69.08	$401.49	$863.42
United Facility/Professional Professional Modifier Low / Median / High Price $306.58 / $384.46 / $694.60	Professional		$306.58	$384.46	$694.60