Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $340.95 / $340.95 / $340.95	Facility		$340.95	$340.95	$340.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.16 / $340.95 / $340.95	Professional		$290.16	$340.95	$340.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $903.63 / $1,800.37 / $3,279.07	Facility		$903.63	$1,800.37	$3,279.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $567.16 / $597.02 / $805.98	Professional		$567.16	$597.02	$805.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $388.06 / $388.06 / $448.62	Facility		$388.06	$388.06	$448.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $477.62 / $477.62 / $477.62	Professional		$477.62	$477.62	$477.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $386.20 / $386.20 / $386.20	Facility		$386.20	$386.20	$386.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.93 / $496.41 / $865.31	Professional		$281.93	$496.41	$865.31
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $340.95 / $431.43 / $431.43	Facility		$340.95	$431.43	$431.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $340.95 / $431.43 / $686.57	Professional		$340.95	$431.43	$686.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $375.52 / $441.79 / $508.05	Professional		$375.52	$441.79	$508.05
United Facility/Professional Professional Modifier Low / Median / High Price $248.21 / $285.41 / $458.97	Professional		$248.21	$285.41	$458.97