Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.58 / $1,217.35 / $4,933.00	Facility		$221.58	$1,217.35	$4,933.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $110.79 / $115.05 / $239.66	Facility	52	$110.79	$115.05	$239.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.32 / $265.89 / $479.32	Professional		$155.32	$265.89	$479.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,394.61 / $2,795.23 / $3,807.87	Facility		$2,394.61	$2,795.23	$3,807.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.96 / $183.13 / $301.33	Professional		$40.96	$183.13	$301.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.12 / $220.21 / $242.28	Facility		$163.12	$220.21	$242.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $348.94 / $415.40 / $437.10	Professional		$348.94	$415.40	$437.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.49 / $294.36 / $600.40	Professional		$180.49	$294.36	$600.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $289.92 / $1,438.50 / $4,228.85	Facility		$289.92	$1,438.50	$4,228.85
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $110.79 / $110.79 / $230.79	Facility	52	$110.79	$110.79	$230.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $159.09 / $384.54 / $604.55	Professional		$159.09	$384.54	$604.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $300.07 / $376.06 / $540.13	Professional		$300.07	$376.06	$540.13
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 $402.09 / $480.39 / $633.73	Professional		$402.09	$480.39	$633.73