Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $790.51 / $790.51 / $790.51	Facility		$790.51	$790.51	$790.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $634.08 / $790.51 / $790.51	Professional		$634.08	$790.51	$790.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,095.11 / $4,174.25 / $7,602.69	Facility		$2,095.11	$4,174.25	$7,602.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,315.01 / $1,384.22 / $1,868.70	Professional		$1,315.01	$1,384.22	$1,868.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $747.21 / $840.20 / $899.74	Facility		$747.21	$840.20	$899.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,107.38 / $1,107.38 / $1,107.38	Professional		$1,107.38	$1,107.38	$1,107.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $895.43 / $895.43 / $895.43	Facility		$895.43	$895.43	$895.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $895.43 / $895.43 / $1,604.63	Professional		$895.43	$895.43	$1,604.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $790.51 / $1,000.29 / $1,000.29	Facility		$790.51	$1,000.29	$1,000.29
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $704.88 / $1,000.29 / $1,453.43	Professional		$704.88	$1,000.29	$1,453.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $839.94 / $1,024.32 / $1,177.96	Professional		$839.94	$1,024.32	$1,177.96
United Facility/Professional Professional Modifier Low / Median / High Price $463.53 / $661.74 / $920.76	Professional		$463.53	$661.74	$920.76