Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $558.92 / $558.92 / $558.92	Facility		$558.92	$558.92	$558.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $558.92 / $558.92	Professional		$392.06	$558.92	$558.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,481.34 / $2,951.40 / $5,375.47	Facility		$1,481.34	$2,951.40	$5,375.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $929.77 / $978.71 / $1,321.26	Professional		$929.77	$978.71	$1,321.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $488.40 / $597.16 / $636.16	Facility		$488.40	$597.16	$636.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $782.97 / $782.97 / $782.97	Professional		$782.97	$782.97	$782.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.36 / $644.36 / $644.36	Facility		$644.36	$644.36	$644.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $644.36 / $644.36 / $1,134.75	Professional		$644.36	$644.36	$1,134.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $558.92 / $707.26 / $707.26	Facility		$558.92	$707.26	$707.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $558.92 / $707.26 / $1,027.64	Professional		$558.92	$707.26	$1,027.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $347.52	Professional		$30.00	$30.00	$347.52
United Facility/Professional Professional Modifier Low / Median / High Price $325.51 / $467.88 / $651.02	Professional		$325.51	$467.88	$651.02