Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $745.32 / $745.32 / $745.32	Facility		$745.32	$745.32	$745.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.94 / $745.32 / $745.32	Professional		$645.94	$745.32	$745.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,975.34 / $3,935.63 / $7,168.08	Facility		$1,975.34	$3,935.63	$7,168.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,239.83 / $1,305.08 / $1,761.87	Professional		$1,239.83	$1,305.08	$1,761.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $741.83 / $824.57 / $848.31	Facility		$741.83	$824.57	$848.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,044.07 / $1,044.07 / $1,044.07	Professional		$1,044.07	$1,044.07	$1,044.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $713.15 / $713.15 / $713.15	Facility		$713.15	$713.15	$713.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $713.14 / $713.15 / $1,513.13	Professional		$713.14	$713.15	$1,513.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $745.32 / $943.12 / $943.12	Facility		$745.32	$943.12	$943.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $745.32 / $943.12 / $1,370.34	Professional		$745.32	$943.12	$1,370.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $791.93 / $965.77 / $1,110.63	Professional		$791.93	$965.77	$1,110.63
United Facility/Professional Professional Modifier Low / Median / High Price $445.81 / $601.99 / $922.39	Professional		$445.81	$601.99	$922.39