Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.33 / $607.23 / $4,933.00	Facility		$65.33	$607.23	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.73 / $96.50 / $132.06	Professional		$62.73	$96.50	$132.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $310.33 / $362.24 / $493.48	Facility		$310.33	$362.24	$493.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.30 / $54.35 / $105.54	Professional		$13.30	$54.35	$105.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.87 / $128.87 / $128.87	Facility		$128.87	$128.87	$128.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $92.86 / $160.66	Professional		$52.75	$92.86	$160.66
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $82.31 / $1,246.10 / $4,933.00	Facility		$82.31	$1,246.10	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $65.33 / $97.36 / $152.09	Professional		$65.33	$97.36	$152.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $102.47 / $146.41	Professional		$81.79	$102.47	$146.41
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.14 / $134.86 / $167.93	Professional		$103.14	$134.86	$167.93