Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $499.43 / $499.43 / $499.43	Facility		$499.43	$499.43	$499.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $451.80 / $499.43 / $566.73	Professional		$451.80	$499.43	$566.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,323.66 / $2,637.23 / $4,803.27	Facility		$1,323.66	$2,637.23	$4,803.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $830.80 / $874.53 / $1,180.61	Professional		$830.80	$874.53	$1,180.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $568.44 / $568.44 / $698.37	Facility		$568.44	$568.44	$698.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $699.62 / $699.62 / $699.62	Professional		$699.62	$699.62	$699.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $565.73 / $565.73 / $565.73	Facility		$565.73	$565.73	$565.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $565.73 / $565.73 / $1,014.00	Professional		$565.73	$565.73	$1,014.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $499.43 / $631.97 / $631.97	Facility		$499.43	$631.97	$631.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $499.43 / $631.97 / $969.02	Professional		$499.43	$631.97	$969.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $530.66 / $647.15 / $744.22	Professional		$530.66	$647.15	$744.22
United Facility/Professional Professional Modifier Low / Median / High Price $341.61 / $418.08 / $625.91	Professional		$341.61	$418.08	$625.91