Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $576.53 / $2,693.00 / $5,715.46	Facility		$576.53	$2,693.00	$5,715.46
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.54 / $38.54 / $115.31	Facility	53	$38.54	$38.54	$115.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.12 / $410.73 / $699.49	Professional		$156.12	$410.73	$699.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,342.59 / $1,567.21 / $2,134.96	Facility		$1,342.59	$1,567.21	$2,134.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.60 / $324.02 / $414.05	Professional		$45.60	$324.02	$414.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $152.81 / $206.29 / $226.96	Facility		$152.81	$206.29	$226.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $459.76 / $547.34 / $573.72	Professional		$459.76	$547.34	$573.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.20 / $347.28 / $924.13	Professional		$175.20	$347.28	$924.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $576.53 / $2,799.90 / $4,933.00	Facility		$576.53	$2,799.90	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $38.54 / $38.54 / $115.31	Facility	53	$38.54	$38.54	$115.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $192.75 / $576.53 / $858.00	Professional		$192.75	$576.53	$858.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $380.93 / $476.60 / $681.87	Professional		$380.93	$476.60	$681.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,527.00 / $4,857.00 / $6,327.00	Facility		$1,527.00	$4,857.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $642.62 / $813.53 / $1,127.35	Professional		$642.62	$813.53	$1,127.35