Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.90 / $26.90 / $26.90	Facility		$26.90	$26.90	$26.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $26.90 / $26.90	Professional		$18.55	$26.90	$26.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.46 / $106.51 / $193.99	Facility		$53.46	$106.51	$193.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $35.32 / $47.68	Professional		$33.54	$35.32	$47.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.96 / $22.96 / $22.96	Facility		$22.96	$22.96	$22.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.26 / $28.26 / $28.26	Professional		$28.26	$28.26	$28.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.60 / $21.22 / $26.21	Facility		$12.60	$21.22	$26.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.60 / $21.22 / $29.37	Professional		$12.60	$21.22	$29.37
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $25.53 / $25.53 / $26.90	Facility		$25.53	$25.53	$26.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $20.55 / $26.90 / $37.08	Professional		$20.55	$26.90	$37.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.40 / $16.75 / $23.45	Professional		$13.40	$16.75	$23.45
United Facility/Professional Professional Modifier Low / Median / High Price $11.73 / $16.59 / $24.96	Professional		$11.73	$16.59	$24.96