Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,408.74 / $1,408.74 / $1,408.74	Facility		$1,408.74	$1,408.74	$1,408.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,408.74 / $1,408.74 / $1,496.79	Professional		$1,408.74	$1,408.74	$1,496.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $548.54 / $562.02 / $565.08	Facility		$548.54	$562.02	$565.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $691.72 / $691.72 / $691.72	Professional		$691.72	$691.72	$691.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.77 / $482.77 / $482.77	Facility		$482.77	$482.77	$482.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $410.35 / $670.03 / $1,112.64	Professional		$410.35	$670.03	$1,112.64
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,408.74 / $1,584.84 / $1,760.93	Facility		$1,408.74	$1,584.84	$1,760.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $864.65 / $1,461.57 / $1,614.18	Professional		$864.65	$1,461.57	$1,614.18
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 $321.20 / $413.35 / $670.03	Professional		$321.20	$413.35	$670.03