Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.69 / $453.69 / $453.69	Facility		$453.69	$453.69	$453.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $387.91 / $453.69 / $517.89	Professional		$387.91	$453.69	$517.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.42 / $2,395.67 / $4,363.33	Facility		$1,202.42	$2,395.67	$4,363.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $754.71 / $794.43 / $1,072.48	Professional		$754.71	$794.43	$1,072.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $514.87 / $516.38 / $686.50	Facility		$514.87	$516.38	$686.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $635.54 / $635.54 / $635.54	Professional		$635.54	$635.54	$635.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $703.94 / $703.94 / $703.94	Facility		$703.94	$703.94	$703.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $598.35 / $703.94 / $921.00	Professional		$598.35	$703.94	$921.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $453.69 / $574.08 / $574.08	Facility		$453.69	$574.08	$574.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $453.69 / $574.08 / $857.33	Professional		$453.69	$574.08	$857.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $482.06 / $587.88 / $676.06	Professional		$482.06	$587.88	$676.06
United Facility/Professional Professional Modifier Low / Median / High Price $329.32 / $395.18 / $608.95	Professional		$329.32	$395.18	$608.95