Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.85 / $175.50 / $499.11	Facility		$53.85	$175.50	$499.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.67 / $256.67 / $292.93	Professional		$256.67	$256.67	$292.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.44 / $121.80 / $216.60	Facility		$88.44	$121.80	$216.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.68 / $81.77 / $98.12	Professional		$77.68	$81.77	$98.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $182.99 / $201.29 / $259.73	Facility		$182.99	$201.29	$259.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $259.73 / $301.37 / $401.45	Professional		$259.73	$301.37	$401.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $272.70 / $272.70	Professional		$54.54	$272.70	$272.70
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.25 / $256.67 / $610.40	Facility		$79.25	$256.67	$610.40
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $256.67 / $283.41 / $340.09	Professional		$256.67	$283.41	$340.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Professional Modifier Low / Median / High Price $267.37 / $267.37 / $292.24	Professional		$267.37	$267.37	$292.24