Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.50 / $2,056.00 / $4,933.00	Facility		$201.50	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.81 / $40.29 / $219.18	Facility	53	$38.81	$40.29	$219.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.26 / $518.76 / $1,095.88	Professional		$146.26	$518.76	$1,095.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,308.84 / $1,525.51 / $2,066.82	Facility		$1,308.84	$1,525.51	$2,066.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.52 / $222.60 / $267.12	Professional		$44.52	$222.60	$267.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.06 / $191.78 / $211.00	Facility		$142.06	$191.78	$211.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $771.18 / $918.08 / $954.80	Professional		$771.18	$918.08	$954.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.63 / $458.55 / $1,437.85	Professional		$146.63	$458.55	$1,437.85
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $931.19 / $2,056.00 / $4,016.38	Facility		$931.19	$2,056.00	$4,016.38
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $38.81 / $38.81 / $211.06	Facility	53	$38.81	$38.81	$211.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $194.03 / $931.19 / $1,203.29	Professional		$194.03	$931.19	$1,203.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $652.03 / $815.04 / $1,170.90	Professional		$652.03	$815.04	$1,170.90
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 $1,047.73 / $1,211.23 / $1,632.98	Professional		$1,047.73	$1,211.23	$1,632.98