Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $902.73 / $902.73 / $902.73	Facility		$902.73	$902.73	$902.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.44 / $902.73 / $1,035.20	Professional		$603.44	$902.73	$1,035.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,144.31 / $4,144.31 / $5,427.05	Facility		$4,144.31	$4,144.31	$5,427.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.93 / $805.17 / $1,144.19	Professional		$86.93	$805.17	$1,144.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.28 / $573.80 / $765.10	Facility		$75.28	$573.80	$765.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.41 / $678.05 / $941.66	Professional		$90.41	$678.05	$941.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $542.66 / $542.66 / $542.66	Facility		$542.66	$542.66	$542.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $542.66 / $542.66 / $1,327.88	Professional		$542.66	$542.66	$1,327.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.07 / $902.73 / $1,384.79	Professional		$100.07	$902.73	$1,384.79
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 $438.86 / $650.29 / $935.28	Professional		$438.86	$650.29	$935.28