Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,296.16 / $1,296.16 / $1,296.16	Facility		$1,296.16	$1,296.16	$1,296.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $716.54 / $1,043.50 / $1,296.16	Professional		$716.54	$1,043.50	$1,296.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,714.28 / $3,753.15 / $7,287.18	Facility		$1,714.28	$3,753.15	$7,287.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.18 / $1,274.71 / $1,811.43	Professional		$134.18	$1,274.71	$1,811.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $86.96 / $86.96 / $87.22	Facility		$86.96	$86.96	$87.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $107.34 / $107.34	Professional		$107.34	$107.34	$107.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $936.57 / $936.57 / $936.57	Facility		$936.57	$936.57	$936.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.92 / $796.08 / $1,865.63	Professional		$112.92	$796.08	$1,865.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $66.75 / $667.49 / $1,296.16	Facility		$66.75	$667.49	$1,296.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $66.75 / $667.49 / $4,830.47	Professional		$66.75	$667.49	$4,830.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $203.33 / $274.49	Professional		$30.00	$203.33	$274.49
United Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $124.84 / $496.52	Professional		$64.48	$124.84	$496.52