Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.60 / $180.37 / $4,933.00	Facility		$91.60	$180.37	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.26 / $119.79 / $198.41	Professional		$71.26	$119.79	$198.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,889.63 / $2,551.60 / $5,992.10	Facility		$1,889.63	$2,551.60	$5,992.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.78 / $19.94 / $121.01	Professional		$14.78	$19.94	$121.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.59 / $73.03 / $87.63	Facility		$57.59	$73.03	$87.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $151.47 / $234.08	Professional		$114.43	$151.47	$234.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.78 / $112.23 / $227.22	Professional		$55.78	$112.23	$227.22
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $91.60 / $180.37 / $4,933.00	Facility		$91.60	$180.37	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.20 / $143.72 / $211.85	Professional		$88.20	$143.72	$211.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $101.78 / $144.21	Professional		$81.79	$101.78	$144.21
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $144.53 / $178.46 / $223.91	Professional		$144.53	$178.46	$223.91