Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.19 / $44.19 / $44.19	Facility		$44.19	$44.19	$44.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.67 / $44.19 / $44.19	Professional		$37.67	$44.19	$44.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.85 / $175.03 / $318.77	Facility		$87.85	$175.03	$318.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $58.04 / $78.34	Professional		$55.14	$58.04	$78.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.47 / $42.47 / $44.38	Facility		$42.47	$42.47	$44.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.24 / $48.24 / $48.24	Professional		$48.24	$48.24	$48.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.02 / $41.02 / $41.02	Facility		$41.02	$41.02	$41.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $38.00 / $79.92	Professional		$34.86	$38.00	$79.92
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $41.94 / $44.19 / $52.46	Facility		$41.94	$44.19	$52.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $35.64 / $44.19 / $60.94	Professional		$35.64	$44.19	$60.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.34 / $36.68 / $49.33	Professional		$29.34	$36.68	$49.33
United Facility/Professional Professional Modifier Low / Median / High Price $22.67 / $27.74 / $41.54	Professional		$22.67	$27.74	$41.54