Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $419.41 / $419.41 / $419.41	Facility		$419.41	$419.41	$419.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.02 / $419.41 / $419.41	Professional		$354.02	$419.41	$419.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,111.54 / $2,214.63 / $4,033.56	Facility		$1,111.54	$2,214.63	$4,033.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $697.67 / $734.39 / $991.43	Professional		$697.67	$734.39	$991.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $425.16 / $457.09 / $477.35	Facility		$425.16	$457.09	$477.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $587.51 / $587.51 / $587.51	Professional		$587.51	$587.51	$587.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.71 / $408.71 / $408.71	Facility		$408.71	$408.71	$408.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $408.71 / $408.71 / $851.25	Professional		$408.71	$408.71	$851.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $419.41 / $530.70 / $530.70	Facility		$419.41	$530.70	$530.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $394.45 / $530.70 / $771.10	Professional		$394.45	$530.70	$771.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $445.62 / $543.45 / $624.96	Professional		$445.62	$543.45	$624.96
United Facility/Professional Professional Modifier Low / Median / High Price $255.50 / $344.87 / $517.54	Professional		$255.50	$344.87	$517.54