Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.81 / $77.81 / $77.81	Facility		$77.81	$77.81	$77.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $77.81 / $79.43	Professional		$52.38	$77.81	$79.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.66 / $308.13 / $561.21	Facility		$154.66	$308.13	$561.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.07 / $102.18 / $137.94	Professional		$97.07	$102.18	$137.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.81 / $66.42 / $66.76	Facility		$64.81	$66.42	$66.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.73 / $81.73 / $81.73	Professional		$81.73	$81.73	$81.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.91 / $82.96 / $131.54	Professional		$43.91	$82.96	$131.54
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $73.84 / $73.84 / $77.81	Facility		$73.84	$73.84	$77.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $77.81 / $115.20	Professional		$62.76	$77.81	$115.20
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 $35.72 / $47.98 / $76.06	Professional		$35.72	$47.98	$76.06