Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $850.29 / $850.29 / $850.29	Facility		$850.29	$850.29	$850.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $706.29 / $850.29 / $850.29	Professional		$706.29	$850.29	$850.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,253.54 / $4,489.93 / $8,177.63	Facility		$2,253.54	$4,489.93	$8,177.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,414.46 / $1,488.90 / $2,010.02	Professional		$1,414.46	$1,488.90	$2,010.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $944.57 / $967.79 / $973.02	Facility		$944.57	$967.79	$973.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,191.11 / $1,191.11 / $1,191.11	Professional		$1,191.11	$1,191.11	$1,191.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.10 / $831.10 / $831.10	Facility		$831.10	$831.10	$831.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.10 / $831.10 / $1,726.13	Professional		$831.10	$831.10	$1,726.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $850.29 / $1,075.93 / $1,075.93	Facility		$850.29	$1,075.93	$1,075.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $850.29 / $1,075.93 / $1,674.63	Professional		$850.29	$1,075.93	$1,674.63
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 $519.54 / $699.19 / $1,052.38	Professional		$519.54	$699.19	$1,052.38