Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $958.66 / $958.66 / $958.66	Facility		$958.66	$958.66	$958.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $764.95 / $958.66 / $958.66	Professional		$764.95	$958.66	$958.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,540.73 / $5,062.10 / $9,219.76	Facility		$2,540.73	$5,062.10	$9,219.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,594.71 / $1,678.64 / $2,266.16	Professional		$1,594.71	$1,678.64	$2,266.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $945.19 / $1,056.15 / $1,091.11	Facility		$945.19	$1,056.15	$1,091.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,342.91 / $1,342.91 / $1,342.91	Professional		$1,342.91	$1,342.91	$1,342.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.63 / $908.63 / $908.63	Facility		$908.63	$908.63	$908.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $908.63 / $908.63 / $1,945.88	Professional		$908.63	$908.63	$1,945.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $958.66 / $1,213.06 / $1,213.06	Facility		$958.66	$1,213.06	$1,213.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $958.66 / $1,213.06 / $1,888.04	Professional		$958.66	$1,213.06	$1,888.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,648.02 / $1,938.85 / $1,938.85	Facility		$1,648.02	$1,938.85	$1,938.85
United Facility/Professional Professional Modifier Low / Median / High Price $604.54 / $802.50 / $1,186.40	Professional		$604.54	$802.50	$1,186.40