Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $468.25 / $468.25 / $468.25	Facility		$468.25	$468.25	$468.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $366.25 / $468.25 / $468.25	Professional		$366.25	$468.25	$468.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,241.00 / $2,472.55 / $4,503.33	Facility		$1,241.00	$2,472.55	$4,503.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $778.92 / $819.92 / $1,106.89	Professional		$778.92	$819.92	$1,106.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $483.36 / $485.49 / $532.95	Facility		$483.36	$485.49	$532.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $655.94 / $655.94 / $655.94	Professional		$655.94	$655.94	$655.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.41 / $530.41 / $530.41	Facility		$530.41	$530.41	$530.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $387.20 / $681.75 / $1,188.28	Professional		$387.20	$681.75	$1,188.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $468.25 / $592.52 / $592.52	Facility		$468.25	$592.52	$592.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $468.25 / $592.52 / $860.91	Professional		$468.25	$592.52	$860.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $497.52 / $606.74 / $697.75	Professional		$497.52	$606.74	$697.75
United Facility/Professional Professional Modifier Low / Median / High Price $309.16 / $391.97 / $586.85	Professional		$309.16	$391.97	$586.85