Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.63 / $2,056.00 / $4,728.17	Facility		$230.63	$2,056.00	$4,728.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.97 / $191.34 / $298.19	Professional		$164.97	$191.34	$298.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $824.88 / $962.89 / $1,311.72	Facility		$824.88	$962.89	$1,311.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.77 / $160.90 / $275.35	Professional		$43.77	$160.90	$275.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.44 / $220.64 / $242.75	Facility		$163.44	$220.64	$242.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $163.04 / $194.10 / $215.36	Professional		$163.04	$194.10	$215.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.51 / $265.07 / $360.39	Professional		$158.51	$265.07	$360.39
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $222.09 / $1,993.79 / $4,933.00	Facility		$222.09	$1,993.79	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $175.90 / $222.09 / $322.61	Professional		$175.90	$222.09	$322.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.30 / $171.18 / $245.14	Professional		$137.30	$171.18	$245.14
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 $211.48 / $263.06 / $356.15	Professional		$211.48	$263.06	$356.15