Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.35 / $421.28 / $1,430.73	Facility		$190.35	$421.28	$1,430.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.36 / $313.69 / $395.26	Professional		$302.36	$313.69	$395.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.90 / $294.58 / $523.85	Facility		$213.90	$294.58	$523.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.87 / $197.76 / $237.31	Professional		$187.87	$197.76	$237.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $380.43 / $418.47 / $539.96	Facility		$380.43	$418.47	$539.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $539.96 / $626.54 / $834.61	Professional		$539.96	$626.54	$834.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.35 / $51.35 / $51.35	Professional		$51.35	$51.35	$51.35
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $206.29 / $421.28 / $1,429.10	Facility		$206.29	$421.28	$1,429.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $302.36 / $377.95 / $453.54	Professional		$302.36	$377.95	$453.54
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 $359.05 / $359.05 / $386.98	Professional		$359.05	$359.05	$386.98