Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $529.17 / $529.17 / $529.17	Facility		$529.17	$529.17	$529.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $456.29 / $529.17 / $529.17	Professional		$456.29	$529.17	$529.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,402.48 / $2,794.29 / $5,089.31	Facility		$1,402.48	$2,794.29	$5,089.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $880.28 / $926.61 / $1,250.92	Professional		$880.28	$926.61	$1,250.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $545.44 / $574.09 / $602.29	Facility		$545.44	$574.09	$602.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $741.29 / $741.29 / $741.29	Professional		$741.29	$741.29	$741.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.34 / $524.34 / $524.34	Facility		$524.34	$524.34	$524.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.34 / $524.34 / $1,074.38	Professional		$524.34	$524.34	$1,074.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $529.17 / $669.61 / $669.61	Facility		$529.17	$669.61	$669.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $497.69 / $669.61 / $972.94	Professional		$497.69	$669.61	$972.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $562.26 / $685.69 / $788.54	Professional		$562.26	$685.69	$788.54
United Facility/Professional Professional Modifier Low / Median / High Price $327.79 / $435.14 / $663.19	Professional		$327.79	$435.14	$663.19