Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,004.40 / $1,004.40 / $1,004.40	Facility		$1,004.40	$1,004.40	$1,004.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $773.19 / $1,004.40 / $1,146.90	Professional		$773.19	$1,004.40	$1,146.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,809.26 / $5,079.03 / $6,651.08	Facility		$3,809.26	$5,079.03	$6,651.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.53 / $1,315.70 / $1,869.68	Professional		$106.53	$1,315.70	$1,869.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.53 / $93.57 / $903.08	Facility		$79.53	$93.57	$903.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.79 / $106.79 / $1,564.32	Professional		$106.79	$106.79	$1,564.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Facility		$200.00	$200.00	$200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.16 / $200.00 / $1,590.00	Professional		$64.16	$200.00	$1,590.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.66 / $706.55 / $1,319.00	Professional		$70.66	$706.55	$1,319.00
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 Professional Modifier Low / Median / High Price $444.05 / $552.61 / $923.96	Professional		$444.05	$552.61	$923.96