Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.27 / $35.27 / $35.27	Facility		$35.27	$35.27	$35.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.72 / $35.27 / $52.53	Professional		$26.72	$35.27	$52.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.76 / $150.93 / $274.89	Facility		$75.76	$150.93	$274.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $50.05 / $67.56	Professional		$47.55	$50.05	$67.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.53 / $32.53 / $38.32	Facility		$32.53	$32.53	$38.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $40.04 / $40.04	Professional		$40.04	$40.04	$40.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $52.17 / $52.17	Facility		$52.17	$52.17	$52.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.17 / $52.17 / $78.09	Professional		$52.17	$52.17	$78.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $35.27 / $60.44 / $60.44	Facility		$35.27	$60.44	$60.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $35.27 / $52.33 / $66.48	Professional		$35.27	$52.33	$66.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $56.57 / $65.05	Professional		$48.08	$56.57	$65.05
United Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $44.11 / $73.51	Professional		$29.56	$44.11	$73.51