Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.38 / $77.38 / $77.38	Facility		$77.38	$77.38	$77.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.76 / $77.38 / $89.50	Professional		$72.76	$77.38	$89.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $205.08 / $408.58 / $744.17	Facility		$205.08	$408.58	$744.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $135.49 / $182.91	Professional		$128.72	$135.49	$182.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.07 / $88.07 / $100.63	Facility		$88.07	$88.07	$100.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.39 / $108.39 / $108.39	Professional		$108.39	$108.39	$108.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $86.88 / $86.88	Facility		$81.70	$86.88	$86.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.70 / $86.88 / $157.13	Professional		$81.70	$86.88	$157.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $77.38 / $97.91 / $97.91	Facility		$77.38	$97.91	$97.91
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $75.58 / $97.91 / $144.54	Professional		$75.58	$97.91	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.21 / $100.26 / $115.29	Professional		$82.21	$100.26	$115.29
United Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $64.77 / $96.97	Professional		$52.92	$64.77	$96.97