Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.23 / $69.23 / $69.23	Facility		$69.23	$69.23	$69.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.32 / $69.23 / $69.23	Professional		$54.32	$69.23	$69.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.51 / $365.61 / $665.90	Facility		$183.51	$365.61	$665.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.18 / $121.24 / $163.66	Professional		$115.18	$121.24	$163.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.12 / $78.81 / $86.64	Facility		$67.12	$78.81	$86.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.99 / $96.99 / $96.99	Professional		$96.99	$96.99	$96.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.47 / $75.47 / $75.47	Facility		$75.47	$75.47	$75.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.47 / $75.47 / $140.63	Professional		$75.47	$75.47	$140.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.23 / $87.62 / $87.62	Facility		$69.23	$87.62	$87.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $65.51 / $87.62 / $127.30	Professional		$65.51	$87.62	$127.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.57 / $89.72 / $103.17	Professional		$73.57	$89.72	$103.17
United Facility/Professional Professional Modifier Low / Median / High Price $40.34 / $56.94 / $83.81	Professional		$40.34	$56.94	$83.81