Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,004.88 / $1,004.88 / $1,004.88	Facility		$1,004.88	$1,004.88	$1,004.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $516.40 / $889.50 / $1,004.88	Professional		$516.40	$889.50	$1,004.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,367.09 / $2,718.14 / $5,251.68	Facility		$1,367.09	$2,718.14	$5,251.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.87 / $101.54 / $130.55	Professional		$91.87	$101.54	$130.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.86 / $87.75 / $197.44	Facility		$62.86	$87.75	$197.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.36 / $77.36 / $77.36	Professional		$77.36	$77.36	$77.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.99 / $24.99 / $4,321.62	Professional		$24.99	$24.99	$4,321.62
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $472.10 / $472.10 / $1,004.88	Facility		$472.10	$472.10	$1,004.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $547.63 / $3,481.20	Professional		$96.70	$547.63	$3,481.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.59 / $176.99 / $238.93	Professional		$141.59	$176.99	$238.93
United Facility/Professional Professional Modifier Low / Median / High Price $46.30 / $103.90 / $363.50	Professional		$46.30	$103.90	$363.50