Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.43 / $490.43 / $898.91	Facility		$490.43	$490.43	$898.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $459.21 / $490.43 / $494.59	Professional		$459.21	$490.43	$494.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,299.79 / $2,589.67 / $4,716.64	Facility		$1,299.79	$2,589.67	$4,716.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $815.82 / $858.76 / $1,159.33	Professional		$815.82	$858.76	$1,159.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $558.19 / $567.40 / $637.36	Facility		$558.19	$567.40	$637.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $687.01 / $687.01 / $687.01	Professional		$687.01	$687.01	$687.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $579.51 / $579.51 / $579.51	Facility		$579.51	$579.51	$579.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $579.51 / $579.51 / $995.63	Professional		$579.51	$579.51	$995.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $490.43 / $620.58 / $898.91	Facility		$490.43	$620.58	$898.91
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $490.43 / $620.58 / $987.57	Professional		$490.43	$620.58	$987.57
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 $338.61 / $406.33 / $621.79	Professional		$338.61	$406.33	$621.79