Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.93 / $66.93 / $66.93	Facility		$66.93	$66.93	$66.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.01 / $66.93 / $69.23	Professional		$58.01	$66.93	$69.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.39 / $353.43 / $643.71	Facility		$177.39	$353.43	$643.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.34 / $117.20 / $158.22	Professional		$111.34	$117.20	$158.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.18 / $85.55 / $88.45	Facility		$76.18	$85.55	$88.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.76 / $93.76 / $93.76	Professional		$93.76	$93.76	$93.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.81 / $75.81 / $75.81	Facility		$75.81	$75.81	$75.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $75.81 / $135.75	Professional		$75.81	$75.81	$135.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $66.93 / $84.68 / $84.68	Facility		$66.93	$84.68	$84.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $66.93 / $84.68 / $123.06	Professional		$66.93	$84.68	$123.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.11 / $86.73 / $99.73	Professional		$71.11	$86.73	$99.73
United Facility/Professional Facility Modifier Low / Median / High Price $88.00 / $88.00 / $88.00	Facility		$88.00	$88.00	$88.00
United Facility/Professional Professional Modifier Low / Median / High Price $45.29 / $56.03 / $83.88	Professional		$45.29	$56.03	$83.88