Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.02 / $255.68 / $4,933.00	Facility		$116.02	$255.68	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.70 / $155.09 / $255.68	Professional		$93.70	$155.09	$255.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $421.00 / $576.39 / $1,535.66	Facility		$421.00	$576.39	$1,535.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.09 / $118.32 / $177.48	Professional		$23.09	$118.32	$177.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $198.86 / $198.86 / $331.80	Facility		$198.86	$198.86	$331.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.74 / $160.74 / $160.74	Facility		$160.74	$160.74	$160.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.79 / $216.50 / $428.69	Professional		$104.79	$216.50	$428.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $255.68 / $4,933.00	Facility		$121.82	$255.68	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $116.02 / $209.24 / $324.57	Professional		$116.02	$209.24	$324.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $189.02 / $230.79 / $326.29	Professional		$189.02	$230.79	$326.29
United Facility/Professional Professional Modifier Low / Median / High Price $188.35 / $229.68 / $332.39	Professional		$188.35	$229.68	$332.39