Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.77 / $53.77 / $53.77	Facility		$53.77	$53.77	$53.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.65 / $53.77 / $61.02	Professional		$48.65	$53.77	$61.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.52 / $283.95 / $517.16	Facility		$142.52	$283.95	$517.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.45 / $94.16 / $127.12	Professional		$89.45	$94.16	$127.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.20 / $61.20 / $61.20	Facility		$61.20	$61.20	$61.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.33 / $75.33 / $75.33	Professional		$75.33	$75.33	$75.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.84 / $58.84 / $58.84	Facility		$58.84	$58.84	$58.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.84 / $58.84 / $109.13	Professional		$58.84	$58.84	$109.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $53.77 / $68.05 / $68.05	Facility		$53.77	$68.05	$68.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $68.05 / $105.91	Professional		$53.77	$68.05	$105.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $33.77	Professional		$30.00	$30.00	$33.77
United Facility/Professional Professional Modifier Low / Median / High Price $36.78 / $45.02 / $67.40	Professional		$36.78	$45.02	$67.40