Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.02 / $43.02 / $43.02	Facility		$43.02	$43.02	$43.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.42 / $43.02 / $43.02	Professional		$30.42	$43.02	$43.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.52 / $170.38 / $310.32	Facility		$85.52	$170.38	$310.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $56.50 / $76.28	Professional		$53.68	$56.50	$76.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.84 / $36.72 / $36.93	Facility		$35.84	$36.72	$36.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.20 / $45.20 / $45.20	Professional		$45.20	$45.20	$45.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $45.89 / $66.28	Professional		$24.24	$45.89	$66.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $40.83 / $40.83 / $43.02	Facility		$40.83	$40.83	$43.02
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $43.02 / $64.97	Professional		$35.86	$43.02	$64.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $48.03	Professional		$30.00	$30.00	$48.03
United Facility/Professional Professional Modifier Low / Median / High Price $19.72 / $26.54 / $39.96	Professional		$19.72	$26.54	$39.96