Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $802.97 / $802.97 / $802.97	Facility		$802.97	$802.97	$802.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $666.99 / $802.97 / $802.97	Professional		$666.99	$802.97	$802.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,128.11 / $4,240.02 / $7,722.48	Facility		$2,128.11	$4,240.02	$7,722.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,335.73 / $1,406.03 / $1,898.14	Professional		$1,335.73	$1,406.03	$1,898.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $892.00 / $913.92 / $918.86	Facility		$892.00	$913.92	$918.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,124.82 / $1,124.82 / $1,124.82	Professional		$1,124.82	$1,124.82	$1,124.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $907.46 / $907.46 / $907.46	Facility		$907.46	$907.46	$907.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $907.46 / $907.46 / $1,630.13	Professional		$907.46	$907.46	$1,630.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $802.97 / $1,016.06 / $1,016.06	Facility		$802.97	$1,016.06	$1,016.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $802.97 / $1,016.06 / $1,581.43	Professional		$802.97	$1,016.06	$1,581.43
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 $490.64 / $653.74 / $993.82	Professional		$490.64	$653.74	$993.82