Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $684.35 / $684.35 / $1,406.11	Facility		$684.35	$684.35	$1,406.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $568.47 / $668.92 / $684.35	Professional		$568.47	$668.92	$684.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,813.76 / $3,613.71 / $6,581.76	Facility		$1,813.76	$3,613.71	$6,581.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,138.42 / $1,198.33 / $1,617.76	Professional		$1,138.42	$1,198.33	$1,617.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $760.24 / $778.92 / $783.13	Facility		$760.24	$778.92	$783.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $958.67 / $958.67 / $958.67	Professional		$958.67	$958.67	$958.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.69 / $736.69 / $958.87	Facility		$736.69	$736.69	$958.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.78 / $996.39 / $1,736.72	Professional		$537.78	$996.39	$1,736.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $684.35 / $865.97 / $1,406.11	Facility		$684.35	$865.97	$1,406.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $642.95 / $865.97 / $1,258.25	Professional		$642.95	$865.97	$1,258.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $727.15 / $886.77 / $1,019.78	Professional		$727.15	$886.77	$1,019.78
United Facility/Professional Professional Modifier Low / Median / High Price $418.16 / $562.74 / $857.67	Professional		$418.16	$562.74	$857.67