Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.52 / $122.19 / $126.46	Facility		$115.52	$122.19	$126.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $25.17 / $30.94	Professional		$14.04	$25.17	$30.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.88 / $20.66 / $26.82	Professional		$18.88	$20.66	$26.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.49 / $39.35 / $63.58	Facility		$26.49	$39.35	$63.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.49 / $29.14 / $35.76	Professional		$26.49	$29.14	$35.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.93 / $13.93 / $36.56	Professional		$13.93	$13.93	$36.56
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $46.25 / $46.25 / $46.25	Facility		$46.25	$46.25	$46.25
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $21.19 / $35.09 / $46.01	Professional		$21.19	$35.09	$46.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $11.13 / $16.16 / $30.57	Professional		$11.13	$16.16	$30.57