Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.81 / $148.47 / $275.87	Facility		$71.81	$148.47	$275.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $71.81 / $88.55	Professional		$69.73	$71.81	$88.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.77 / $52.77 / $52.77	Facility		$52.77	$52.77	$52.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $52.77 / $71.23	Professional		$50.13	$52.77	$71.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.32 / $45.32 / $45.32	Facility		$45.32	$45.32	$45.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $65.90 / $65.90	Professional		$65.90	$65.90	$65.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $69.73 / $95.63	Facility		$69.73	$69.73	$95.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $81.00 / $109.24	Professional		$69.73	$81.00	$109.24
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $146.50 / $275.87	Facility		$69.73	$146.50	$275.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $71.81 / $93.86	Professional		$69.73	$71.81	$93.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.27 / $79.50 / $87.45	Professional		$59.27	$79.50	$87.45
United Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $69.73 / $78.09	Professional		$27.89	$69.73	$78.09