Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.04 / $69.04 / $69.04	Facility		$69.04	$69.04	$69.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.39 / $69.04 / $69.04	Professional		$52.39	$69.04	$69.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.98 / $364.56 / $663.98	Facility		$182.98	$364.56	$663.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.85 / $120.89 / $163.19	Professional		$114.85	$120.89	$163.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.72 / $73.48 / $78.58	Facility		$64.72	$73.48	$78.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.71 / $96.71 / $96.71	Professional		$96.71	$96.71	$96.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.68 / $71.68 / $71.68	Facility		$71.68	$71.68	$71.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.68 / $71.68 / $140.25	Professional		$71.68	$71.68	$140.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.04 / $87.35 / $87.35	Facility		$69.04	$87.35	$87.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $63.29 / $87.35 / $126.93	Professional		$63.29	$87.35	$126.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.35 / $89.46 / $102.87	Professional		$73.35	$89.46	$102.87
United Facility/Professional Facility Modifier Low / Median / High Price $106.31 / $125.07 / $125.07	Facility		$106.31	$125.07	$125.07
United Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $56.41 / $80.42	Professional		$39.00	$56.41	$80.42