Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.53 / $571.66 / $4,933.00	Facility		$195.53	$571.66	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.25 / $195.53 / $219.34	Professional		$183.25	$195.53	$219.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.48 / $79.48 / $248.36	Facility		$79.48	$79.48	$248.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $377.51 / $476.86	Professional		$79.48	$377.51	$476.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $206.40 / $278.64 / $306.56	Facility		$206.40	$278.64	$306.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $205.54 / $244.69 / $272.20	Professional		$205.54	$244.69	$272.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.08 / $311.70 / $343.69	Professional		$217.08	$311.70	$343.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $246.36 / $571.66 / $4,933.00	Facility		$246.36	$571.66	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $183.25 / $195.53 / $815.10	Professional		$183.25	$195.53	$815.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $479.40 / $479.40	Professional		$30.00	$479.40	$479.40