Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $459.03 / $459.03 / $459.03	Facility		$459.03	$459.03	$459.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.99 / $459.03 / $459.03	Professional		$349.99	$459.03	$459.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,216.57 / $2,423.88 / $4,414.68	Facility		$1,216.57	$2,423.88	$4,414.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $763.59 / $803.78 / $1,085.09	Professional		$763.59	$803.78	$1,085.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $416.27 / $469.19 / $522.46	Facility		$416.27	$469.19	$522.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $643.02 / $643.02 / $643.02	Professional		$643.02	$643.02	$643.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.16 / $400.16 / $400.16	Facility		$400.16	$400.16	$400.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.16 / $400.16 / $931.88	Professional		$400.16	$400.16	$931.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $459.03 / $580.85 / $580.85	Facility		$459.03	$580.85	$580.85
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $431.72 / $580.85 / $843.96	Professional		$431.72	$580.85	$843.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $505.58 / $594.79 / $684.02	Professional		$505.58	$594.79	$684.02
United Facility/Professional Facility Modifier Low / Median / High Price $725.80 / $853.88 / $853.88	Facility		$725.80	$853.88	$853.88
United Facility/Professional Professional Modifier Low / Median / High Price $266.25 / $377.46 / $534.66	Professional		$266.25	$377.46	$534.66