Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.87 / $80.87 / $80.87	Facility		$80.87	$80.87	$80.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.18 / $80.87 / $80.87	Professional		$57.18	$80.87	$80.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.76 / $320.29 / $583.35	Facility		$160.76	$320.29	$583.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.90 / $106.21 / $143.38	Professional		$100.90	$106.21	$143.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.38 / $69.04 / $69.41	Facility		$67.38	$69.04	$69.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.97 / $84.97 / $84.97	Professional		$84.97	$84.97	$84.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $86.24 / $124.23	Professional		$45.55	$86.24	$124.23
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $76.75 / $76.75 / $80.87	Facility		$76.75	$76.75	$80.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.42 / $80.87 / $122.14	Professional		$67.42	$80.87	$122.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $90.28	Professional		$30.00	$30.00	$90.28
United Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $50.77 / $76.02	Professional		$37.07	$50.77	$76.02