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 $55.28 / $65.51 / $65.51	Professional		$55.28	$65.51	$65.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.64 / $345.95 / $630.09	Facility		$173.64	$345.95	$630.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.98 / $114.72 / $154.87	Professional		$108.98	$114.72	$154.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.25 / $69.55 / $74.56	Facility		$61.25	$69.55	$74.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.78 / $91.78 / $91.78	Professional		$91.78	$91.78	$91.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.37 / $81.37 / $81.37	Facility		$81.37	$81.37	$81.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.37 / $81.37 / $133.13	Professional		$81.37	$81.37	$133.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $65.51 / $82.88 / $82.88	Facility		$65.51	$82.88	$82.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.62 / $82.88 / $120.45	Professional		$61.62	$82.88	$120.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.60 / $84.89 / $97.62	Professional		$69.60	$84.89	$97.62
United Facility/Professional Professional Modifier Low / Median / High Price $36.81 / $53.86 / $98.39	Professional		$36.81	$53.86	$98.39