Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $564.25 / $564.25 / $564.25	Facility		$564.25	$564.25	$564.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $476.83 / $564.25 / $564.25	Professional		$476.83	$564.25	$564.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,495.44 / $2,979.50 / $5,426.66	Facility		$1,495.44	$2,979.50	$5,426.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $938.63 / $988.03 / $1,333.84	Professional		$938.63	$988.03	$1,333.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $626.85 / $642.22 / $645.69	Facility		$626.85	$642.22	$645.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $790.42 / $790.42 / $790.42	Professional		$790.42	$790.42	$790.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $551.53 / $551.53 / $551.53	Facility		$551.53	$551.53	$551.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.62 / $551.53 / $1,145.25	Professional		$402.62	$551.53	$1,145.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $564.25 / $713.99 / $713.99	Facility		$564.25	$713.99	$713.99
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $552.12 / $713.99 / $1,037.43	Professional		$552.12	$713.99	$1,037.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $366.96 / $463.98 / $673.84	Professional		$366.96	$463.98	$673.84