Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.15 / $74.15 / $74.15	Facility		$74.15	$74.15	$74.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.33 / $74.15 / $74.15	Professional		$47.33	$74.15	$74.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $196.52 / $391.55 / $713.13	Facility		$196.52	$391.55	$713.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.35 / $129.84 / $175.28	Professional		$123.35	$129.84	$175.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.30 / $81.80 / $84.40	Facility		$63.30	$81.80	$84.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.87 / $103.87 / $103.87	Professional		$103.87	$103.87	$103.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.99 / $83.99 / $83.99	Facility		$83.99	$83.99	$83.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.99 / $83.99 / $150.38	Professional		$83.99	$83.99	$150.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $14.76 / $93.82 / $93.82	Facility		$14.76	$93.82	$93.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $93.82 / $136.33	Professional		$69.73	$93.82	$136.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.78 / $96.08 / $110.49	Professional		$78.78	$96.08	$110.49
United Facility/Professional Professional Modifier Low / Median / High Price $40.49 / $60.97 / $92.92	Professional		$40.49	$60.97	$92.92