Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $392.41 / $392.41 / $392.41	Facility		$392.41	$392.41	$392.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.01 / $392.41 / $392.41	Professional		$327.01	$392.41	$392.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,040.00 / $2,072.08 / $3,773.94	Facility		$1,040.00	$2,072.08	$3,773.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $652.76 / $687.12 / $927.61	Professional		$652.76	$687.12	$927.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $373.74 / $427.86 / $446.63	Facility		$373.74	$427.86	$446.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $549.70 / $549.70 / $549.70	Professional		$549.70	$549.70	$549.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $444.49 / $444.49 / $444.49	Facility		$444.49	$444.49	$444.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $444.49 / $444.49 / $796.50	Professional		$444.49	$444.49	$796.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $392.41 / $496.54 / $496.54	Facility		$392.41	$496.54	$496.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $392.41 / $496.54 / $772.83	Professional		$392.41	$496.54	$772.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $206.19	Professional		$30.00	$30.00	$206.19
United Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $108.00 / $108.00	Facility		$108.00	$108.00	$108.00
United Facility/Professional Professional Modifier Low / Median / High Price $239.04 / $328.49 / $478.08	Professional		$239.04	$328.49	$478.08