Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.11 / $53.11 / $53.11	Facility		$53.11	$53.11	$53.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $53.11 / $53.11	Professional		$38.47	$53.11	$53.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.57 / $210.34 / $383.09	Facility		$105.57	$210.34	$383.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.26 / $69.75 / $94.16	Professional		$66.26	$69.75	$94.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.34 / $45.34 / $45.34	Facility		$45.34	$45.34	$45.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $55.80 / $55.80	Professional		$55.80	$55.80	$55.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.70 / $37.70 / $38.83	Facility		$37.70	$37.70	$38.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $37.70 / $58.00	Professional		$32.04	$37.70	$58.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $50.40 / $53.11	Facility		$50.40	$50.40	$53.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $41.89 / $53.11 / $78.45	Professional		$41.89	$53.11	$78.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $34.43 / $48.20	Professional		$27.54	$34.43	$48.20
United Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $32.75 / $49.91	Professional		$23.16	$32.75	$49.91