Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $484.85 / $484.85 / $484.85	Facility		$484.85	$484.85	$484.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.53 / $484.85 / $484.85	Professional		$394.53	$484.85	$484.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,285.01 / $2,560.23 / $4,663.05	Facility		$1,285.01	$2,560.23	$4,663.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $806.55 / $849.00 / $1,146.15	Professional		$806.55	$849.00	$1,146.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $418.76 / $522.98 / $551.85	Facility		$418.76	$522.98	$551.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $679.20 / $679.20 / $679.20	Professional		$679.20	$679.20	$679.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $402.56 / $402.56 / $402.56	Facility		$402.56	$402.56	$402.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.56 / $402.56 / $984.38	Professional		$402.56	$402.56	$984.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $484.85 / $613.53 / $613.53	Facility		$484.85	$613.53	$613.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $484.85 / $613.53 / $954.91	Professional		$484.85	$613.53	$954.91
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 Professional Modifier Low / Median / High Price $267.83 / $405.88 / $607.65	Professional		$267.83	$405.88	$607.65