Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $613.99 / $613.99 / $613.99	Facility		$613.99	$613.99	$613.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $429.46 / $613.99 / $613.99	Professional		$429.46	$613.99	$613.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,627.28 / $3,242.16 / $5,905.04	Facility		$1,627.28	$3,242.16	$5,905.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,021.37 / $1,075.13 / $1,451.43	Professional		$1,021.37	$1,075.13	$1,451.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $569.28 / $583.99 / $698.83	Facility		$569.28	$583.99	$698.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $860.10 / $860.10 / $860.10	Professional		$860.10	$860.10	$860.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $695.50 / $695.50 / $695.50	Facility		$695.50	$695.50	$695.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $695.50 / $695.50 / $1,246.50	Professional		$695.50	$695.50	$1,246.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $613.99 / $776.96 / $776.96	Facility		$613.99	$776.96	$776.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $613.99 / $776.96 / $1,209.25	Professional		$613.99	$776.96	$1,209.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $652.39 / $795.60 / $914.94	Professional		$652.39	$795.60	$914.94
United Facility/Professional Professional Modifier Low / Median / High Price $372.13 / $513.98 / $715.16	Professional		$372.13	$513.98	$715.16