Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $65.81 / $65.81	Facility		$65.81	$65.81	$65.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.01 / $65.81 / $65.81	Professional		$42.01	$65.81	$65.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.46 / $347.58 / $633.04	Facility		$174.46	$347.58	$633.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.50 / $115.26 / $155.60	Professional		$109.50	$115.26	$155.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.19 / $56.19 / $74.92	Facility		$56.19	$56.19	$74.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.21 / $92.21 / $92.21	Professional		$92.21	$92.21	$92.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.02 / $54.02 / $54.02	Facility		$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $95.83 / $166.88	Professional		$39.43	$95.83	$166.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $83.29 / $83.29	Facility		$65.81	$83.29	$83.29
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $83.29 / $121.02	Professional		$60.34	$83.29	$121.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.93 / $85.29 / $98.08	Professional		$69.93	$85.29	$98.08
United Facility/Professional Facility Modifier Low / Median / High Price $97.97 / $115.26 / $115.26	Facility		$97.97	$115.26	$115.26
United Facility/Professional Professional Modifier Low / Median / High Price $33.77 / $53.17 / $77.01	Professional		$33.77	$53.17	$77.01