Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $521.51 / $521.51 / $521.51	Facility		$521.51	$521.51	$521.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $401.65 / $521.51 / $521.51	Professional		$401.65	$521.51	$521.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,382.16 / $2,753.79 / $5,015.55	Facility		$1,382.16	$2,753.79	$5,015.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $867.52 / $913.18 / $1,232.79	Professional		$867.52	$913.18	$1,232.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $525.66 / $535.91 / $593.57	Facility		$525.66	$535.91	$593.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $730.54 / $730.54 / $730.54	Professional		$730.54	$730.54	$730.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $649.92 / $649.92 / $649.92	Facility		$649.92	$649.92	$649.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $649.92 / $649.92 / $1,058.63	Professional		$649.92	$649.92	$1,058.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $521.51 / $659.90 / $659.90	Facility		$521.51	$659.90	$659.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $521.51 / $659.90 / $1,027.08	Professional		$521.51	$659.90	$1,027.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $554.11 / $675.75 / $777.11	Professional		$554.11	$675.75	$777.11
United Facility/Professional Professional Modifier Low / Median / High Price $336.22 / $436.56 / $645.40	Professional		$336.22	$436.56	$645.40