Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $413.74 / $413.74 / $413.74	Facility		$413.74	$413.74	$413.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $344.79 / $413.74 / $413.74	Professional		$344.79	$413.74	$413.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,096.54 / $2,184.73 / $3,979.13	Facility		$1,096.54	$2,184.73	$3,979.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $688.26 / $724.48 / $978.05	Professional		$688.26	$724.48	$978.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $407.76 / $425.65 / $470.91	Facility		$407.76	$425.65	$470.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $579.58 / $579.58 / $579.58	Professional		$579.58	$579.58	$579.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.67 / $468.67 / $468.67	Facility		$468.67	$468.67	$468.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $468.67 / $468.67 / $840.00	Professional		$468.67	$468.67	$840.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $413.74 / $523.54 / $523.54	Facility		$413.74	$523.54	$523.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $413.74 / $523.54 / $814.86	Professional		$413.74	$523.54	$814.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $299.67	Professional		$30.00	$30.00	$299.67
United Facility/Professional Facility Modifier Low / Median / High Price $383.20 / $383.20 / $383.20	Facility		$383.20	$383.20	$383.20
United Facility/Professional Professional Modifier Low / Median / High Price $260.55 / $346.36 / $518.53	Professional		$260.55	$346.36	$518.53