Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.17 / $26.17 / $26.17	Facility		$26.17	$26.17	$26.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.68 / $26.17 / $26.17	Professional		$22.68	$26.17	$26.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.34 / $138.16 / $251.66	Facility		$69.34	$138.16	$251.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.53 / $45.82 / $61.86	Professional		$43.53	$45.82	$61.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.78 / $31.63 / $31.97	Facility		$29.78	$31.63	$31.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $36.65 / $36.65	Professional		$36.65	$36.65	$36.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.64 / $29.64 / $29.64	Facility		$29.64	$29.64	$29.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.64 / $30.61 / $59.11	Professional		$21.64	$30.61	$59.11
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $26.17 / $33.11 / $33.11	Facility		$26.17	$33.11	$33.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $33.11 / $51.54	Professional		$26.17	$33.11	$51.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $17.48 / $21.91 / $32.79	Professional		$17.48	$21.91	$32.79