Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $395.77 / $395.77 / $395.77	Facility		$395.77	$395.77	$395.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.75 / $395.77 / $395.77	Professional		$328.75	$395.77	$395.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,048.90 / $2,089.81 / $3,806.23	Facility		$1,048.90	$2,089.81	$3,806.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $658.35 / $693.00 / $935.55	Professional		$658.35	$693.00	$935.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $439.65 / $450.45 / $452.91	Facility		$439.65	$450.45	$452.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $554.40 / $554.40 / $554.40	Professional		$554.40	$554.40	$554.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $386.84 / $386.84 / $386.84	Facility		$386.84	$386.84	$386.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $386.83 / $386.84 / $803.25	Professional		$386.83	$386.84	$803.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $395.77 / $500.79 / $500.79	Facility		$395.77	$500.79	$500.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $395.77 / $500.79 / $727.65	Professional		$395.77	$500.79	$727.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $420.51 / $512.82 / $589.74	Professional		$420.51	$512.82	$589.74
United Facility/Professional Professional Modifier Low / Median / High Price $241.83 / $325.43 / $463.04	Professional		$241.83	$325.43	$463.04