Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $672.86 / $672.86 / $672.86	Facility		$672.86	$672.86	$672.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $608.69 / $672.86 / $763.53	Professional		$608.69	$672.86	$763.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,783.29 / $3,553.01 / $6,471.20	Facility		$1,783.29	$3,553.01	$6,471.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,119.30 / $1,178.21 / $1,590.58	Professional		$1,119.30	$1,178.21	$1,590.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $765.84 / $765.84 / $766.84	Facility		$765.84	$765.84	$766.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $942.57 / $942.57 / $942.57	Professional		$942.57	$942.57	$942.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.22 / $736.22 / $736.22	Facility		$736.22	$736.22	$736.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $736.22 / $736.22 / $1,365.75	Professional		$736.22	$736.22	$1,365.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $672.86 / $851.43 / $851.43	Facility		$672.86	$851.43	$851.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $672.86 / $851.43 / $1,341.27	Professional		$672.86	$851.43	$1,341.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $714.94 / $871.88 / $1,002.66	Professional		$714.94	$871.88	$1,002.66
United Facility/Professional Professional Modifier Low / Median / High Price $460.24 / $563.26 / $843.27	Professional		$460.24	$563.26	$843.27