Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.94 / $423.31 / $664.58	Facility		$112.94	$423.31	$664.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.07 / $180.00 / $198.00	Professional		$106.07	$180.00	$198.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.92 / $419.58 / $859.34	Facility		$182.92	$419.58	$859.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.64 / $127.83 / $216.28	Professional		$51.64	$127.83	$216.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.22 / $62.83 / $118.40	Facility		$39.22	$62.83	$118.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.18 / $62.83 / $113.99	Professional		$42.18	$62.83	$113.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.91 / $78.91 / $360.05	Professional		$78.91	$78.91	$360.05
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $129.15 / $497.08 / $648.00	Facility		$129.15	$497.08	$648.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $106.88 / $180.00 / $305.00	Professional		$106.88	$180.00	$305.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $100.00	Professional		$30.00	$75.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $137.18 / $218.52 / $275.95	Professional		$137.18	$218.52	$275.95