Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $919.87 / $919.87 / $919.87	Facility		$919.87	$919.87	$919.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $847.33 / $919.87 / $1,043.82	Professional		$847.33	$919.87	$1,043.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,437.92 / $4,857.29 / $8,846.71	Facility		$2,437.92	$4,857.29	$8,846.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,530.18 / $1,610.72 / $2,174.46	Professional		$1,530.18	$1,610.72	$2,174.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,046.97 / $1,046.97 / $1,334.32	Facility		$1,046.97	$1,046.97	$1,334.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,288.58 / $1,288.58 / $1,288.58	Professional		$1,288.58	$1,288.58	$1,288.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,006.48 / $1,006.48 / $1,006.48	Facility		$1,006.48	$1,006.48	$1,006.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $734.73 / $1,339.29 / $2,334.38	Professional		$734.73	$1,339.29	$2,334.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $919.87 / $1,163.98 / $1,163.98	Facility		$919.87	$1,163.98	$1,163.98
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $919.87 / $1,163.98 / $1,691.25	Professional		$919.87	$1,163.98	$1,691.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,013.14 / $1,191.93 / $1,370.71	Professional		$1,013.14	$1,191.93	$1,370.71
United Facility/Professional Facility Modifier Low / Median / High Price $820.00 / $820.00 / $820.00	Facility		$820.00	$820.00	$820.00
United Facility/Professional Professional Modifier Low / Median / High Price $629.19 / $770.03 / $1,152.83	Professional		$629.19	$770.03	$1,152.83