Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $57.57 / $57.57	Facility		$57.57	$57.57	$57.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $57.57 / $57.57	Professional		$40.54	$57.57	$57.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.60 / $304.02 / $553.74	Facility		$152.60	$304.02	$553.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.78 / $100.82 / $136.11	Professional		$95.78	$100.82	$136.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.15 / $59.87 / $65.53	Facility		$49.15	$59.87	$65.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.66 / $80.66 / $80.66	Professional		$80.66	$80.66	$80.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.20 / $65.20 / $79.79	Facility		$65.20	$65.20	$79.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.20 / $65.20 / $117.00	Professional		$65.20	$65.20	$117.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $72.84 / $72.84	Facility		$57.57	$72.84	$72.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $72.84 / $105.86	Professional		$52.92	$72.84	$105.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.18 / $74.61 / $85.80	Professional		$61.18	$74.61	$85.80
United Facility/Professional Professional Modifier Low / Median / High Price $29.54 / $45.46 / $67.06	Professional		$29.54	$45.46	$67.06