Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.56 / $39.56 / $39.56	Facility		$39.56	$39.56	$39.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.51 / $35.76 / $39.56	Professional		$22.51	$35.76	$39.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.33 / $144.09 / $273.86	Facility		$69.33	$144.09	$273.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.39 / $49.69 / $62.11	Professional		$45.39	$49.69	$62.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.78 / $64.50 / $78.84	Facility		$47.78	$64.50	$78.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.17 / $62.11 / $110.78	Professional		$50.17	$62.11	$110.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $28.69 / $69.38	Professional		$28.69	$28.69	$69.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $39.56 / $47.19 / $54.26	Facility		$39.56	$47.19	$54.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $47.19 / $61.88	Professional		$39.56	$47.19	$61.88
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 $19.78 / $30.12 / $46.73	Professional		$19.78	$30.12	$46.73