Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $582.97 / $582.97 / $582.97	Facility		$582.97	$582.97	$582.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $440.01 / $582.97 / $582.97	Professional		$440.01	$582.97	$582.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,545.03 / $3,078.29 / $5,606.59	Facility		$1,545.03	$3,078.29	$5,606.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $969.75 / $1,020.79 / $1,378.07	Professional		$969.75	$1,020.79	$1,378.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $543.66 / $619.52 / $663.51	Facility		$543.66	$619.52	$663.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $816.63 / $816.63 / $816.63	Professional		$816.63	$816.63	$816.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $510.69 / $510.69 / $510.69	Facility		$510.69	$510.69	$510.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $510.69 / $510.69 / $1,183.50	Professional		$510.69	$510.69	$1,183.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $582.97 / $737.68 / $737.68	Facility		$582.97	$737.68	$737.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $582.97 / $737.68 / $1,071.82	Professional		$582.97	$737.68	$1,071.82
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 $339.78 / $488.01 / $721.46	Professional		$339.78	$488.01	$721.46