Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.33 / $630.33 / $1,140.05	Facility		$630.33	$630.33	$1,140.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $523.59 / $630.33 / $630.33	Professional		$523.59	$630.33	$630.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,670.56 / $3,328.41 / $6,062.13	Facility		$1,670.56	$3,328.41	$6,062.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,048.54 / $1,103.73 / $1,490.04	Professional		$1,048.54	$1,103.73	$1,490.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $700.23 / $717.42 / $721.31	Facility		$700.23	$717.42	$721.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $882.98 / $882.98 / $882.98	Professional		$882.98	$882.98	$882.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.27 / $616.27 / $616.27	Facility		$616.27	$616.27	$616.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.27 / $616.27 / $1,279.50	Professional		$616.27	$616.27	$1,279.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $630.33 / $754.92 / $1,140.05	Facility		$630.33	$754.92	$1,140.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $630.33 / $754.92 / $1,158.91	Professional		$630.33	$754.92	$1,158.91
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 $391.74 / $526.09 / $835.71	Professional		$391.74	$526.09	$835.71