Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $658.25 / $658.25 / $658.25	Facility		$658.25	$658.25	$658.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.80 / $658.25 / $746.95	Professional		$562.80	$658.25	$746.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,744.56 / $3,475.84 / $6,330.65	Facility		$1,744.56	$3,475.84	$6,330.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,094.99 / $1,152.61 / $1,556.04	Professional		$1,094.99	$1,152.61	$1,556.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $749.20 / $749.20 / $749.20	Facility		$749.20	$749.20	$749.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $922.10 / $922.10 / $922.10	Professional		$922.10	$922.10	$922.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.21 / $812.21 / $812.21	Facility		$812.21	$812.21	$812.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.21 / $812.21 / $1,336.13	Professional		$812.21	$812.21	$1,336.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $658.25 / $832.93 / $832.93	Facility		$658.25	$832.93	$832.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $658.25 / $832.93 / $1,294.74	Professional		$658.25	$832.93	$1,294.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $699.41 / $852.94 / $980.88	Professional		$699.41	$852.94	$980.88
United Facility/Professional Professional Modifier Low / Median / High Price $479.19 / $573.75 / $886.10	Professional		$479.19	$573.75	$886.10