Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.60 / $45.60 / $45.60	Facility		$45.60	$45.60	$45.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.60 / $45.60 / $57.00	Professional		$45.60	$45.60	$57.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,664.92 / $3,317.16 / $6,041.64	Facility		$1,664.92	$3,317.16	$6,041.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,045.00 / $1,100.00 / $1,485.00	Professional		$1,045.00	$1,100.00	$1,485.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,259.23 / $1,259.23 / $1,259.23	Professional		$1,259.23	$1,259.23	$1,259.23
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $45.60 / $45.60 / $45.60	Facility		$45.60	$45.60	$45.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $45.60 / $45.60 / $57.00	Professional		$45.60	$45.60	$57.00