Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.58 / $1,886.00 / $3,902.99	Facility		$141.58	$1,886.00	$3,902.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.06 / $141.58 / $156.79	Professional		$121.06	$141.58	$156.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.84 / $80.04 / $112.61	Facility		$67.84	$80.04	$112.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.13 / $128.03 / $221.22	Professional		$31.13	$128.03	$221.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $161.15 / $170.06 / $179.60	Facility		$161.15	$170.06	$179.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $198.34 / $198.34 / $198.34	Professional		$198.34	$198.34	$198.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.78 / $195.78 / $195.78	Facility		$195.78	$195.78	$195.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.67 / $195.78 / $318.85	Professional		$165.67	$195.78	$318.85
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $141.58 / $2,374.06 / $4,887.50	Facility		$141.58	$2,374.06	$4,887.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $141.58 / $179.17 / $297.50	Professional		$141.58	$179.17	$297.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.81 / $30.00 / $30.00	Professional		$6.81	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.67 / $118.52 / $182.45	Professional		$98.67	$118.52	$182.45