Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.84 / $66.84 / $66.84	Facility		$66.84	$66.84	$66.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.88 / $66.84 / $66.84	Professional		$56.88	$66.84	$66.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.15 / $352.95 / $642.83	Facility		$177.15	$352.95	$642.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.19 / $117.04 / $158.00	Professional		$111.19	$117.04	$158.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.08 / $76.08 / $76.08	Facility		$76.08	$76.08	$76.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.63 / $93.63 / $93.63	Professional		$93.63	$93.63	$93.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.70 / $75.70 / $75.70	Facility		$75.70	$75.70	$75.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $75.70 / $150.68	Professional		$27.00	$75.70	$150.68
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $66.84 / $84.57 / $84.57	Facility		$66.84	$84.57	$84.57
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $84.57 / $140.44	Professional		$66.84	$84.57	$140.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.81 / $30.00 / $30.00	Professional		$6.81	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $54.96 / $83.76	Professional		$43.80	$54.96	$83.76