Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $358.08 / $358.08 / $358.08	Facility		$358.08	$358.08	$358.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.63 / $316.24 / $358.08	Professional		$240.63	$316.24	$358.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $637.04 / $1,266.58 / $2,447.16	Facility		$637.04	$1,266.58	$2,447.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.81 / $47.31 / $60.83	Professional		$42.81	$47.31	$60.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.29 / $31.43 / $47.57	Facility		$29.29	$31.43	$47.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $36.04 / $38.68	Professional		$36.04	$36.04	$38.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.33 / $558.75 / $709.61	Professional		$34.33	$558.75	$709.61
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $22.00 / $219.96 / $358.08	Facility		$22.00	$219.96	$358.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $219.96 / $1,622.16	Professional		$22.00	$219.96	$1,622.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $25.82 / $51.63	Professional		$17.50	$25.82	$51.63