Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $797.39 / $797.39 / $797.39	Facility		$797.39	$797.39	$797.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $626.82 / $797.39 / $797.39	Professional		$626.82	$797.39	$797.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,113.33 / $4,210.56 / $7,668.82	Facility		$2,113.33	$4,210.56	$7,668.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,326.45 / $1,396.26 / $1,884.95	Professional		$1,326.45	$1,396.26	$1,884.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $752.10 / $791.90 / $907.57	Facility		$752.10	$791.90	$907.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,117.01 / $1,117.01 / $1,117.01	Professional		$1,117.01	$1,117.01	$1,117.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $930.44 / $930.44 / $930.44	Facility		$930.44	$930.44	$930.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $930.44 / $930.44 / $1,618.88	Professional		$930.44	$930.44	$1,618.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $797.39 / $1,009.01 / $1,009.01	Facility		$797.39	$1,009.01	$1,009.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $797.39 / $1,009.01 / $1,466.07	Professional		$797.39	$1,009.01	$1,466.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $847.24 / $1,033.23 / $1,188.21	Professional		$847.24	$1,033.23	$1,188.21
United Facility/Professional Professional Modifier Low / Median / High Price $481.05 / $667.50 / $932.94	Professional		$481.05	$667.50	$932.94