Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.98 / $222.83 / $4,933.00	Facility		$77.98	$222.83	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.29 / $133.36 / $222.83	Professional		$64.29	$133.36	$222.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $362.76 / $496.65 / $1,323.23	Facility		$362.76	$496.65	$1,323.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.37 / $78.88 / $118.32	Professional		$16.37	$78.88	$118.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.06 / $165.06 / $275.39	Facility		$165.06	$165.06	$275.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.24 / $107.24 / $107.24	Facility		$107.24	$107.24	$107.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $185.69 / $387.66	Professional		$71.34	$185.69	$387.66
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $81.87 / $233.97 / $4,933.00	Facility		$81.87	$233.97	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $165.06 / $273.07	Professional		$70.73	$165.06	$273.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $159.08 / $197.65 / $279.29	Professional		$159.08	$197.65	$279.29
United Facility/Professional Professional Modifier Low / Median / High Price $152.30 / $204.63 / $302.75	Professional		$152.30	$204.63	$302.75