Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $647.08 / $647.08 / $647.08	Facility		$647.08	$647.08	$647.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $560.79 / $647.08 / $647.08	Professional		$560.79	$647.08	$647.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,714.96 / $3,416.86 / $6,223.22	Facility		$1,714.96	$3,416.86	$6,223.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,076.41 / $1,133.06 / $1,529.63	Professional		$1,076.41	$1,133.06	$1,529.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $734.11 / $736.49 / $757.19	Facility		$734.11	$736.49	$757.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $906.45 / $906.45 / $906.45	Professional		$906.45	$906.45	$906.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $732.96 / $732.96 / $732.96	Facility		$732.96	$732.96	$732.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $535.05 / $942.12 / $1,642.03	Professional		$535.05	$942.12	$1,642.03
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $647.08 / $818.81 / $818.81	Facility		$647.08	$818.81	$818.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $618.76 / $818.81 / $1,189.71	Professional		$618.76	$818.81	$1,189.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $687.53 / $838.46 / $964.22	Professional		$687.53	$838.46	$964.22
United Facility/Professional Facility Modifier Low / Median / High Price $1,173.99 / $1,381.17 / $1,381.17	Facility		$1,173.99	$1,381.17	$1,381.17
United Facility/Professional Professional Modifier Low / Median / High Price $430.66 / $532.09 / $810.95	Professional		$430.66	$532.09	$810.95