Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $690.73 / $690.73 / $2,859.25	Facility		$690.73	$690.73	$2,859.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $573.74 / $690.73 / $690.73	Professional		$573.74	$690.73	$690.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,830.64 / $3,647.34 / $6,643.00	Facility		$1,830.64	$3,647.34	$6,643.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,149.02 / $1,209.49 / $1,632.81	Professional		$1,149.02	$1,209.49	$1,632.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $767.31 / $786.17 / $790.43	Facility		$767.31	$786.17	$790.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $967.59 / $967.59 / $967.59	Professional		$967.59	$967.59	$967.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $944.53 / $944.53 / $944.53	Facility		$944.53	$944.53	$944.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $944.53 / $944.53 / $1,402.13	Professional		$944.53	$944.53	$1,402.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $690.73 / $874.03 / $2,859.25	Facility		$690.73	$874.03	$2,859.25
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $675.89 / $874.03 / $1,269.96	Professional		$675.89	$874.03	$1,269.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $733.91 / $895.02 / $1,029.27	Professional		$733.91	$895.02	$1,029.27
United Facility/Professional Professional Modifier Low / Median / High Price $449.20 / $567.98 / $824.86	Professional		$449.20	$567.98	$824.86