Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $613.66 / $613.66 / $613.66	Facility		$613.66	$613.66	$613.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $509.74 / $613.66 / $613.66	Professional		$509.74	$613.66	$613.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,626.43 / $3,240.47 / $5,901.97	Facility		$1,626.43	$3,240.47	$5,901.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,020.84 / $1,074.57 / $1,450.67	Professional		$1,020.84	$1,074.57	$1,450.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $681.70 / $698.47 / $702.24	Facility		$681.70	$698.47	$702.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $859.66 / $859.66 / $859.66	Professional		$859.66	$859.66	$859.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $695.41 / $695.41 / $695.41	Facility		$695.41	$695.41	$695.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $695.41 / $695.41 / $1,245.75	Professional		$695.41	$695.41	$1,245.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $613.66 / $776.52 / $776.52	Facility		$613.66	$776.52	$776.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $600.47 / $776.52 / $1,128.29	Professional		$600.47	$776.52	$1,128.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $652.04 / $795.18 / $914.45	Professional		$652.04	$795.18	$914.45
United Facility/Professional Professional Modifier Low / Median / High Price $374.97 / $504.61 / $759.52	Professional		$374.97	$504.61	$759.52