Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $541.12 / $541.12 / $541.12	Facility		$541.12	$541.12	$541.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.93 / $541.12 / $567.26	Professional		$450.93	$541.12	$567.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,434.13 / $2,857.34 / $5,204.16	Facility		$1,434.13	$2,857.34	$5,204.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $900.14 / $947.52 / $1,279.15	Professional		$900.14	$947.52	$1,279.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $568.98 / $568.98 / $615.89	Facility		$568.98	$568.98	$615.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $758.02 / $758.02 / $758.02	Professional		$758.02	$758.02	$758.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $612.94 / $612.94 / $612.94	Facility		$612.94	$612.94	$612.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $612.94 / $612.94 / $1,098.38	Professional		$612.94	$612.94	$1,098.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $541.12 / $684.72 / $684.72	Facility		$541.12	$684.72	$684.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $541.12 / $684.72 / $1,065.72	Professional		$541.12	$684.72	$1,065.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $418.56	Professional		$30.00	$30.00	$418.56
United Facility/Professional Facility Modifier Low / Median / High Price $7.21 / $577.08 / $672.95	Facility		$7.21	$577.08	$672.95
United Facility/Professional Professional Modifier Low / Median / High Price $363.92 / $452.98 / $678.16	Professional		$363.92	$452.98	$678.16