Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $567.53 / $567.53 / $567.53	Facility		$567.53	$567.53	$567.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $513.41 / $567.53 / $644.01	Professional		$513.41	$567.53	$644.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,504.15 / $2,996.84 / $5,458.24	Facility		$1,504.15	$2,996.84	$5,458.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $944.09 / $993.78 / $1,341.60	Professional		$944.09	$993.78	$1,341.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $645.96 / $645.96 / $682.34	Facility		$645.96	$645.96	$682.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $795.02 / $795.02 / $795.02	Professional		$795.02	$795.02	$795.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $620.97 / $620.97 / $620.97	Facility		$620.97	$620.97	$620.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $620.97 / $620.97 / $1,152.00	Professional		$620.97	$620.97	$1,152.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $567.53 / $718.15 / $718.15	Facility		$567.53	$718.15	$718.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $567.53 / $718.15 / $1,043.46	Professional		$567.53	$718.15	$1,043.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $603.02 / $735.40 / $845.71	Professional		$603.02	$735.40	$845.71
United Facility/Professional Professional Modifier Low / Median / High Price $388.20 / $475.09 / $711.27	Professional		$388.20	$475.09	$711.27