Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $434.81 / $434.81 / $434.81	Facility		$434.81	$434.81	$434.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $373.86 / $434.81 / $434.81	Professional		$373.86	$434.81	$434.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.36 / $2,295.96 / $4,181.68	Facility		$1,152.36	$2,295.96	$4,181.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $723.29 / $761.36 / $1,027.83	Professional		$723.29	$761.36	$1,027.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $425.04 / $494.88 / $500.13	Facility		$425.04	$494.88	$500.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $609.09 / $609.09 / $609.09	Professional		$609.09	$609.09	$609.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.60 / $408.60 / $408.60	Facility		$408.60	$408.60	$408.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $408.60 / $408.60 / $882.75	Professional		$408.60	$408.60	$882.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $434.81 / $550.19 / $550.19	Facility		$434.81	$550.19	$550.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $408.94 / $550.19 / $799.42	Professional		$408.94	$550.19	$799.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $461.99 / $563.41 / $647.92	Professional		$461.99	$563.41	$647.92
United Facility/Professional Professional Modifier Low / Median / High Price $255.43 / $357.53 / $544.91	Professional		$255.43	$357.53	$544.91