Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $791.05 / $791.05 / $791.05	Facility		$791.05	$791.05	$791.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $685.57 / $791.05 / $791.05	Professional		$685.57	$791.05	$791.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,096.51 / $4,177.06 / $7,607.80	Facility		$2,096.51	$4,177.06	$7,607.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,315.89 / $1,385.15 / $1,869.95	Professional		$1,315.89	$1,385.15	$1,869.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $782.41 / $866.92 / $900.35	Facility		$782.41	$866.92	$900.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,108.11 / $1,108.11 / $1,108.11	Professional		$1,108.11	$1,108.11	$1,108.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $752.15 / $752.15 / $752.15	Facility		$752.15	$752.15	$752.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.07 / $1,151.73 / $2,007.19	Professional		$549.07	$1,151.73	$2,007.19
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $791.05 / $1,000.99 / $1,000.99	Facility		$791.05	$1,000.99	$1,000.99
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $754.08 / $1,000.99 / $1,454.40	Professional		$754.08	$1,000.99	$1,454.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $840.50 / $1,025.01 / $1,178.76	Professional		$840.50	$1,025.01	$1,178.76
United Facility/Professional Professional Modifier Low / Median / High Price $500.43 / $650.48 / $991.39	Professional		$500.43	$650.48	$991.39