Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.54 / $73.54 / $73.54	Facility		$73.54	$73.54	$73.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.73 / $73.54 / $74.90	Professional		$63.73	$73.54	$74.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.89 / $388.29 / $707.20	Facility		$194.89	$388.29	$707.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.32 / $128.76 / $173.83	Professional		$122.32	$128.76	$173.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.69 / $83.69 / $98.47	Facility		$83.69	$83.69	$98.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.01 / $103.01 / $103.01	Professional		$103.01	$103.01	$103.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $80.45 / $80.45	Facility		$80.45	$80.45	$80.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $80.45 / $149.25	Professional		$80.45	$80.45	$149.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $73.54 / $93.05 / $93.05	Facility		$73.54	$93.05	$93.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $73.54 / $93.05 / $135.19	Professional		$73.54	$93.05	$135.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $95.28 / $109.57	Professional		$78.12	$95.28	$109.57
United Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $64.23 / $92.15	Professional		$50.30	$64.23	$92.15