Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.51 / $65.51 / $65.51	Facility		$65.51	$65.51	$65.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.01 / $65.51 / $86.26	Professional		$52.01	$65.51	$86.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.44 / $293.75 / $535.01	Facility		$147.44	$293.75	$535.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.54 / $97.41 / $131.50	Professional		$92.54	$97.41	$131.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.32 / $63.32 / $69.11	Facility		$63.32	$63.32	$69.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.93 / $77.93 / $77.93	Professional		$77.93	$77.93	$77.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.68 / $76.68 / $76.68	Facility		$76.68	$76.68	$76.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.68 / $76.68 / $133.66	Professional		$76.68	$76.68	$133.66
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $65.51 / $116.16 / $116.16	Facility		$65.51	$116.16	$116.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $65.51 / $97.41 / $128.08	Professional		$65.51	$97.41	$128.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.03 / $98.82 / $113.64	Professional		$81.03	$98.82	$113.64
United Facility/Professional Facility Modifier Low / Median / High Price $1.18 / $71.01 / $90.90	Facility		$1.18	$71.01	$90.90
United Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $75.48 / $115.04	Professional		$48.52	$75.48	$115.04