Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.36 / $82.36 / $82.36	Facility		$82.36	$82.36	$82.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.67 / $82.36 / $82.36	Professional		$59.67	$82.36	$82.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $163.72 / $326.20 / $594.11	Facility		$163.72	$326.20	$594.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.76 / $108.17 / $146.03	Professional		$102.76	$108.17	$146.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.31 / $70.31 / $70.31	Facility		$70.31	$70.31	$70.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $86.54 / $86.54 / $86.54	Professional		$86.54	$86.54	$86.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.13 / $76.44 / $125.25	Professional		$44.13	$76.44	$125.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $78.15 / $78.15 / $82.36	Facility		$78.15	$78.15	$82.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $64.95 / $82.36 / $121.65	Professional		$64.95	$82.36	$121.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.72 / $53.41 / $74.77	Professional		$42.72	$53.41	$74.77
United Facility/Professional Professional Modifier Low / Median / High Price $35.92 / $50.79 / $77.40	Professional		$35.92	$50.79	$77.40