Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $392.11 / $392.11 / $392.11	Facility		$392.11	$392.11	$392.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.18 / $392.11 / $392.11	Professional		$316.18	$392.11	$392.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,039.21 / $2,070.51 / $3,771.08	Facility		$1,039.21	$2,070.51	$3,771.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $652.27 / $686.60 / $926.91	Professional		$652.27	$686.60	$926.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $379.83 / $389.68 / $446.29	Facility		$379.83	$389.68	$446.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $549.28 / $549.28 / $549.28	Professional		$549.28	$549.28	$549.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $483.85 / $483.85 / $483.85	Facility		$483.85	$483.85	$483.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $483.85 / $483.85 / $796.13	Professional		$483.85	$483.85	$796.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $392.11 / $496.18 / $496.18	Facility		$392.11	$496.18	$496.18
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $392.11 / $496.18 / $720.93	Professional		$392.11	$496.18	$720.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $416.62 / $508.08 / $584.29	Professional		$416.62	$508.08	$584.29
United Facility/Professional Facility Modifier Low / Median / High Price $389.42 / $389.42 / $389.42	Facility		$389.42	$389.42	$389.42
United Facility/Professional Professional Modifier Low / Median / High Price $242.94 / $328.24 / $462.36	Professional		$242.94	$328.24	$462.36