Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.37 / $207.81 / $2,167.19	Facility		$97.37	$207.81	$2,167.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $120.00 / $230.13	Professional		$66.34	$120.00	$230.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $382.73 / $382.73 / $382.73	Professional	50	$382.73	$382.73	$382.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $135.13 / $158.61 / $214.90	Facility		$135.13	$158.61	$214.90
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $77.83 / $110.51 / $139.91	Facility	50	$77.83	$110.51	$139.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.70 / $72.47 / $146.31	Professional		$13.70	$72.47	$146.31
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $136.08 / $250.61 / $294.83	Professional	50	$136.08	$250.61	$294.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.28 / $86.09 / $103.31	Facility		$68.28	$86.09	$103.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $186.25 / $286.61	Professional		$140.82	$186.25	$286.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.61 / $122.79 / $220.10	Professional		$66.61	$122.79	$220.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $97.37 / $368.05 / $2,878.00	Facility		$97.37	$368.05	$2,878.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.69 / $137.11 / $261.49	Professional		$88.69	$137.11	$261.49
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $106.31 / $106.31 / $382.73	Professional	50	$106.31	$106.31	$382.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.71 / $135.73 / $192.57	Professional		$108.71	$135.73	$192.57
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $3,005.00 / $4,504.00	Facility		$645.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.52 / $157.66 / $216.79	Professional		$131.52	$157.66	$216.79