Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.42 / $54.42 / $54.42	Facility		$54.42	$54.42	$54.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.20 / $54.42 / $54.42	Professional		$46.20	$54.42	$54.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.22 / $287.36 / $523.37	Facility		$144.22	$287.36	$523.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.53 / $95.29 / $128.63	Professional		$90.53	$95.29	$128.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.94 / $63.43 / $70.54	Facility		$61.94	$63.43	$70.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $76.23 / $76.23	Professional		$76.23	$76.23	$76.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.62 / $61.62 / $61.62	Facility		$61.62	$61.62	$61.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.62 / $61.62 / $110.63	Professional		$61.62	$61.62	$110.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $54.42 / $68.84 / $68.84	Facility		$54.42	$68.84	$68.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $51.18 / $68.84 / $100.05	Professional		$51.18	$68.84	$100.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.81 / $70.51 / $81.08	Professional		$57.81	$70.51	$81.08
United Facility/Professional Professional Modifier Low / Median / High Price $33.84 / $44.74 / $64.40	Professional		$33.84	$44.74	$64.40