Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $867.76 / $867.76 / $867.76	Facility		$867.76	$867.76	$867.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $727.77 / $867.76 / $867.76	Professional		$727.77	$867.76	$867.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,299.81 / $4,582.10 / $8,345.54	Facility		$2,299.81	$4,582.10	$8,345.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,443.50 / $1,519.47 / $2,051.28	Professional		$1,443.50	$1,519.47	$2,051.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $866.00 / $941.27 / $987.66	Facility		$866.00	$941.27	$987.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,215.58 / $1,215.58 / $1,215.58	Professional		$1,215.58	$1,215.58	$1,215.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $832.50 / $832.50 / $832.50	Facility		$832.50	$832.50	$832.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $832.50 / $832.50 / $1,761.38	Professional		$832.50	$832.50	$1,761.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $867.76 / $1,098.04 / $1,098.04	Facility		$867.76	$1,098.04	$1,098.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $816.12 / $1,098.04 / $1,595.44	Professional		$816.12	$1,098.04	$1,595.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $922.01 / $1,124.41 / $1,293.07	Professional		$922.01	$1,124.41	$1,293.07
United Facility/Professional Professional Modifier Low / Median / High Price $553.90 / $713.55 / $1,087.51	Professional		$553.90	$713.55	$1,087.51