Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.84 / $36.84 / $36.84	Facility		$36.84	$36.84	$36.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.62 / $36.84 / $36.84	Professional		$15.62	$36.84	$36.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.23 / $145.88 / $265.72	Facility		$73.23	$145.88	$265.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.96 / $48.38 / $65.31	Professional		$45.96	$48.38	$65.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.61 / $28.61 / $31.45	Facility		$28.61	$28.61	$31.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.53 / $38.53 / $38.53	Professional		$38.53	$38.53	$38.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.06 / $29.06 / $29.06	Facility		$29.06	$29.06	$29.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.93 / $29.06 / $40.22	Professional		$22.93	$29.06	$40.22
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $34.95 / $34.95 / $36.84	Facility		$34.95	$34.95	$36.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $24.29 / $36.84 / $50.79	Professional		$24.29	$36.84	$50.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.34 / $22.93 / $32.10	Professional		$18.34	$22.93	$32.10
United Facility/Professional Professional Modifier Low / Median / High Price $16.05 / $22.31 / $33.36	Professional		$16.05	$22.31	$33.36