Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $932.90 / $932.90 / $932.90	Facility		$932.90	$932.90	$932.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $824.73 / $932.90 / $932.90	Professional		$824.73	$932.90	$932.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,472.48 / $4,926.13 / $8,972.11	Facility		$2,472.48	$4,926.13	$8,972.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,551.87 / $1,633.55 / $2,205.29	Professional		$1,551.87	$1,633.55	$2,205.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,037.65 / $1,061.81 / $1,235.49	Facility		$1,037.65	$1,061.81	$1,235.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,306.83 / $1,306.83 / $1,306.83	Professional		$1,306.83	$1,306.83	$1,306.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,030.36 / $1,030.36 / $1,030.36	Facility		$1,030.36	$1,030.36	$1,030.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $752.17 / $1,358.26 / $2,367.19	Professional		$752.17	$1,358.26	$2,367.19
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $932.90 / $1,180.45 / $1,180.45	Facility		$932.90	$1,180.45	$1,180.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $932.90 / $1,180.45 / $1,715.22	Professional		$932.90	$1,180.45	$1,715.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,027.50 / $1,208.83 / $1,390.15	Professional		$1,027.50	$1,208.83	$1,390.15
United Facility/Professional Professional Modifier Low / Median / High Price $623.59 / $780.93 / $1,169.14	Professional		$623.59	$780.93	$1,169.14