Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $995.55 / $995.55 / $995.55	Facility		$995.55	$995.55	$995.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $800.24 / $995.55 / $995.55	Professional		$800.24	$995.55	$995.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,638.52 / $5,256.94 / $9,574.62	Facility		$2,638.52	$5,256.94	$9,574.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,656.09 / $1,743.25 / $2,353.39	Professional		$1,656.09	$1,743.25	$2,353.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $931.01 / $1,058.08 / $1,133.10	Facility		$931.01	$1,058.08	$1,133.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,394.60 / $1,394.60 / $1,394.60	Professional		$1,394.60	$1,394.60	$1,394.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $895.00 / $895.00 / $895.00	Facility		$895.00	$895.00	$895.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $895.00 / $895.00 / $2,020.88	Professional		$895.00	$895.00	$2,020.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $995.55 / $1,259.74 / $1,259.74	Facility		$995.55	$1,259.74	$1,259.74
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $995.55 / $1,259.74 / $1,830.41	Professional		$995.55	$1,259.74	$1,830.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,057.80 / $1,290.00 / $1,483.50	Professional		$1,057.80	$1,290.00	$1,483.50
United Facility/Professional Professional Modifier Low / Median / High Price $595.48 / $833.38 / $1,164.78	Professional		$595.48	$833.38	$1,164.78