Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.80 / $184.25 / $1,103.91	Facility		$28.80	$184.25	$1,103.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $28.80 / $32.86	Professional		$28.80	$28.80	$32.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.26 / $94.01 / $167.17	Facility		$68.26	$94.01	$167.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.95 / $63.11 / $75.73	Professional		$59.95	$63.11	$75.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.82 / $29.50 / $38.06	Facility		$26.82	$29.50	$38.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.06 / $44.17 / $58.81	Professional		$38.06	$44.17	$58.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.60 / $30.60 / $30.60	Professional		$30.60	$30.60	$30.60
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $28.80 / $151.25 / $1,171.32	Facility		$28.80	$151.25	$1,171.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $31.80 / $38.15	Professional		$28.80	$31.80	$38.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $32.40	Professional		$30.00	$30.00	$32.40