Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $907.53 / $907.53 / $907.53	Facility		$907.53	$907.53	$907.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $753.84 / $907.53 / $907.53	Professional		$753.84	$907.53	$907.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,405.25 / $4,792.18 / $8,728.14	Facility		$2,405.25	$4,792.18	$8,728.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,509.67 / $1,589.13 / $2,145.33	Professional		$1,509.67	$1,589.13	$2,145.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,008.15 / $1,032.93 / $1,038.52	Facility		$1,008.15	$1,032.93	$1,038.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,271.30 / $1,271.30 / $1,271.30	Professional		$1,271.30	$1,271.30	$1,271.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,115.23 / $1,115.23 / $1,115.23	Facility		$1,115.23	$1,115.23	$1,115.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $814.12 / $1,115.23 / $1,842.38	Professional		$814.12	$1,115.23	$1,842.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $907.53 / $1,148.38 / $1,148.38	Facility		$907.53	$1,148.38	$1,148.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $853.53 / $1,148.38 / $1,668.58	Professional		$853.53	$1,148.38	$1,668.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $999.56 / $1,175.96 / $1,352.35	Professional		$999.56	$1,175.96	$1,352.35
United Facility/Professional Professional Modifier Low / Median / High Price $554.53 / $746.26 / $1,137.36	Professional		$554.53	$746.26	$1,137.36