Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.78 / $59.16 / $184.58	Facility		$57.78	$59.16	$184.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $57.78 / $69.48	Professional		$56.10	$57.78	$69.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.16 / $122.34 / $233.11	Facility		$65.16	$122.34	$233.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.29 / $57.15 / $57.15	Professional		$54.29	$57.15	$57.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.80 / $76.80 / $76.80	Facility		$76.80	$76.80	$76.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.14 / $56.10 / $56.10	Professional		$49.14	$56.10	$56.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $73.95 / $164.61	Facility		$56.10	$73.95	$164.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $57.78 / $67.31	Professional		$56.10	$57.78	$67.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.77 / $64.51 / $66.04	Professional		$59.77	$64.51	$66.04
United Facility/Professional Facility Modifier Low / Median / High Price $56.06 / $56.10 / $56.10	Facility		$56.06	$56.10	$56.10
United Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $56.10 / $59.52	Professional		$56.10	$56.10	$59.52