Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $976.40 / $976.40 / $976.40	Facility		$976.40	$976.40	$976.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $769.50 / $976.40 / $976.40	Professional		$769.50	$976.40	$976.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,587.77 / $5,155.83 / $9,390.46	Facility		$2,587.77	$5,155.83	$9,390.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,624.23 / $1,709.72 / $2,308.12	Professional		$1,624.23	$1,709.72	$2,308.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $952.92 / $1,020.02 / $1,111.32	Facility		$952.92	$1,020.02	$1,111.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,367.78 / $1,367.78 / $1,367.78	Professional		$1,367.78	$1,367.78	$1,367.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,105.99 / $1,105.99 / $1,105.99	Facility		$1,105.99	$1,105.99	$1,105.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,105.99 / $1,105.99 / $1,982.25	Professional		$1,105.99	$1,105.99	$1,982.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $976.40 / $1,235.52 / $1,235.52	Facility		$976.40	$1,235.52	$1,235.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $976.40 / $1,235.52 / $1,922.99	Professional		$976.40	$1,235.52	$1,922.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $556.77	Professional		$30.00	$30.00	$556.77
United Facility/Professional Professional Modifier Low / Median / High Price $650.94 / $802.89 / $1,223.67	Professional		$650.94	$802.89	$1,223.67