Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.34 / $80.34 / $80.34	Facility		$80.34	$80.34	$80.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.04 / $80.34 / $124.14	Professional		$64.04	$80.34	$124.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.54 / $361.69 / $658.76	Facility		$181.54	$361.69	$658.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $119.94 / $161.91	Professional		$113.94	$119.94	$161.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.95 / $77.95 / $91.84	Facility		$77.95	$77.95	$91.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.95 / $95.95 / $95.95	Professional		$95.95	$95.95	$95.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $133.72	Facility		$133.72	$133.72	$133.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.72 / $133.72 / $162.80	Professional		$133.72	$133.72	$162.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $80.34 / $141.49 / $141.49	Facility		$80.34	$141.49	$141.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $120.26 / $156.00	Professional		$80.34	$120.26	$156.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.27 / $124.72 / $143.42	Professional		$102.27	$124.72	$143.42
United Facility/Professional Professional Modifier Low / Median / High Price $65.12 / $93.60 / $140.13	Professional		$65.12	$93.60	$140.13