Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $452.72 / $452.72 / $452.72	Facility		$452.72	$452.72	$452.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.36 / $452.72 / $452.72	Professional		$392.36	$452.72	$452.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,199.85 / $2,390.59 / $4,354.05	Facility		$1,199.85	$2,390.59	$4,354.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $753.10 / $792.74 / $1,070.20	Professional		$753.10	$792.74	$1,070.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $466.87 / $515.28 / $537.21	Facility		$466.87	$515.28	$537.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $634.19 / $634.19 / $634.19	Professional		$634.19	$634.19	$634.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.80 / $512.80 / $512.80	Facility		$512.80	$512.80	$512.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.80 / $512.80 / $919.13	Professional		$512.80	$512.80	$919.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $452.72 / $572.86 / $572.86	Facility		$452.72	$572.86	$572.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $434.78 / $572.86 / $832.37	Professional		$434.78	$572.86	$832.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $481.03 / $586.63 / $674.62	Professional		$481.03	$586.63	$674.62
United Facility/Professional Professional Modifier Low / Median / High Price $280.57 / $372.27 / $567.38	Professional		$280.57	$372.27	$567.38