Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $906.88 / $906.88 / $906.88	Facility		$906.88	$906.88	$906.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $755.73 / $906.88 / $906.88	Professional		$755.73	$906.88	$906.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,403.51 / $4,788.71 / $8,721.82	Facility		$2,403.51	$4,788.71	$8,721.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,508.58 / $1,587.98 / $2,143.77	Professional		$1,508.58	$1,587.98	$2,143.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,007.44 / $1,032.19 / $1,037.78	Facility		$1,007.44	$1,032.19	$1,037.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,270.38 / $1,270.38 / $1,270.38	Professional		$1,270.38	$1,270.38	$1,270.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,111.22 / $1,111.22 / $1,111.22	Facility		$1,111.22	$1,111.22	$1,111.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $811.19 / $1,320.38 / $2,301.09	Professional		$811.19	$1,320.38	$2,301.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $906.88 / $1,147.54 / $1,147.54	Facility		$906.88	$1,147.54	$1,147.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $906.88 / $1,147.54 / $1,786.08	Professional		$906.88	$1,147.54	$1,786.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $998.84 / $1,175.10 / $1,351.37	Professional		$998.84	$1,175.10	$1,351.37
United Facility/Professional Professional Modifier Low / Median / High Price $589.91 / $759.16 / $1,136.54	Professional		$589.91	$759.16	$1,136.54