Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $95.00 / $150.00	Facility		$79.00	$95.00	$150.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.55 / $120.00 / $124.85	Professional		$81.55	$120.00	$124.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.18 / $112.10 / $198.67	Facility		$78.18	$112.10	$198.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $75.00 / $101.25	Professional		$51.00	$75.00	$101.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $100.00 / $244.39	Facility		$75.00	$100.00	$244.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $100.00	Professional		$65.00	$65.00	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.61 / $114.81 / $143.52	Professional		$57.61	$114.81	$143.52
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.40 / $95.00 / $174.56	Facility		$79.40	$95.00	$174.56
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $74.14 / $99.75 / $124.84	Professional		$74.14	$99.75	$124.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $82.80 / $111.78	Professional		$30.00	$82.80	$111.78
United Facility/Professional Professional Modifier Low / Median / High Price $36.63 / $52.33 / $65.01	Professional		$36.63	$52.33	$65.01