Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.63 / $53.63 / $53.63	Facility		$53.63	$53.63	$53.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.32 / $50.44 / $53.63	Professional		$45.32	$50.44	$53.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.13 / $283.19 / $515.79	Facility		$142.13	$283.19	$515.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.21 / $93.91 / $126.78	Professional		$89.21	$93.91	$126.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.57 / $61.04 / $61.38	Facility		$59.57	$61.04	$61.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.13 / $75.13 / $75.13	Professional		$75.13	$75.13	$75.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $58.60 / $58.60	Facility		$58.60	$58.60	$58.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $58.60 / $108.75	Professional		$47.55	$58.60	$108.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $53.63 / $67.87 / $67.87	Facility		$53.63	$67.87	$67.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $67.87 / $98.60	Professional		$50.39	$67.87	$98.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $69.48 / $79.91	Professional		$56.98	$69.48	$79.91
United Facility/Professional Professional Modifier Low / Median / High Price $32.78 / $44.11 / $67.22	Professional		$32.78	$44.11	$67.22