Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.71 / $28.71 / $28.71	Facility		$28.71	$28.71	$28.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.80 / $28.71 / $28.71	Professional		$20.80	$28.71	$28.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.08 / $113.72 / $207.12	Facility		$57.08	$113.72	$207.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.82 / $37.71 / $50.91	Professional		$35.82	$37.71	$50.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.51 / $24.51 / $24.81	Facility		$24.51	$24.51	$24.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $30.17 / $30.17	Professional		$30.17	$30.17	$30.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.51 / $26.66 / $32.93	Facility		$22.51	$26.66	$32.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.51 / $26.66 / $32.93	Professional		$22.51	$26.66	$32.93
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $27.25 / $27.25 / $28.71	Facility		$27.25	$27.25	$28.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $28.71 / $41.95	Professional		$23.16	$28.71	$41.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.91 / $23.64 / $32.04	Professional		$18.91	$23.64	$32.04
United Facility/Professional Professional Modifier Low / Median / High Price $14.73 / $18.82 / $26.99	Professional		$14.73	$18.82	$26.99