Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.63 / $78.63 / $78.63	Facility		$78.63	$78.63	$78.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.85 / $78.63 / $78.63	Professional		$57.85	$78.63	$78.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.39 / $415.19 / $756.19	Facility		$208.39	$415.19	$756.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.80 / $137.68 / $185.87	Professional		$130.80	$137.68	$185.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.12 / $72.78 / $89.49	Facility		$67.12	$72.78	$89.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.14 / $110.14 / $110.14	Professional		$110.14	$110.14	$110.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.52 / $64.52 / $64.52	Facility		$64.52	$64.52	$64.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.52 / $64.52 / $159.75	Professional		$64.52	$64.52	$159.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $78.63 / $99.49 / $99.49	Facility		$78.63	$99.49	$99.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $73.95 / $99.49 / $144.56	Professional		$73.95	$99.49	$144.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.54 / $101.88 / $117.16	Professional		$83.54	$101.88	$117.16
United Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $62.08 / $91.99	Professional		$42.93	$62.08	$91.99