Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.06 / $43.06 / $43.06	Facility		$43.06	$43.06	$43.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.20 / $43.06 / $43.06	Professional		$31.20	$43.06	$43.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.61 / $170.56 / $310.64	Facility		$85.61	$170.56	$310.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.73 / $56.56 / $76.36	Professional		$53.73	$56.56	$76.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.76 / $36.76 / $36.76	Facility		$36.76	$36.76	$36.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.25 / $45.25 / $45.25	Professional		$45.25	$45.25	$45.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.97 / $33.97 / $35.97	Facility		$33.97	$33.97	$35.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $35.97 / $65.63	Professional		$29.70	$35.97	$65.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $40.86 / $40.86 / $43.06	Facility		$40.86	$40.86	$43.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $43.06 / $65.04	Professional		$35.90	$43.06	$65.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $48.08	Professional		$30.00	$30.00	$48.08
United Facility/Professional Professional Modifier Low / Median / High Price $18.78 / $26.56 / $39.97	Professional		$18.78	$26.56	$39.97