Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $505.14 / $505.14 / $505.14	Facility		$505.14	$505.14	$505.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $403.73 / $505.14 / $505.14	Professional		$403.73	$505.14	$505.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,338.78 / $2,667.36 / $4,858.14	Facility		$1,338.78	$2,667.36	$4,858.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $840.29 / $884.52 / $1,194.09	Professional		$840.29	$884.52	$1,194.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $498.86 / $542.29 / $574.94	Facility		$498.86	$542.29	$574.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $707.62 / $707.62 / $707.62	Professional		$707.62	$707.62	$707.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $572.20 / $572.20 / $572.20	Facility		$572.20	$572.20	$572.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $572.20 / $572.20 / $1,025.25	Professional		$572.20	$572.20	$1,025.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $505.14 / $639.21 / $639.21	Facility		$505.14	$639.21	$639.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $505.14 / $639.21 / $928.74	Professional		$505.14	$639.21	$928.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $536.72 / $654.54 / $752.72	Professional		$536.72	$654.54	$752.72
United Facility/Professional Professional Modifier Low / Median / High Price $319.07 / $422.86 / $591.03	Professional		$319.07	$422.86	$591.03