Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.54 / $43.54 / $43.54	Facility		$43.54	$43.54	$43.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.19 / $43.54 / $49.41	Professional		$39.19	$43.54	$49.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.41 / $229.94 / $418.80	Facility		$115.41	$229.94	$418.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $76.25 / $102.94	Professional		$72.44	$76.25	$102.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.56 / $49.56 / $52.63	Facility		$49.56	$49.56	$52.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $61.00 / $61.00	Professional		$61.00	$61.00	$61.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.11 / $54.11 / $54.11	Facility		$54.11	$54.11	$54.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $54.11 / $88.50	Professional		$54.11	$54.11	$88.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $43.54 / $55.10 / $55.10	Facility		$43.54	$55.10	$55.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $55.10 / $80.06	Professional		$42.82	$55.10	$80.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.27 / $56.43 / $64.89	Professional		$46.27	$56.43	$64.89
United Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $48.00	Facility		$48.00	$48.00	$48.00
United Facility/Professional Professional Modifier Low / Median / High Price $29.78 / $36.45 / $54.57	Professional		$29.78	$36.45	$54.57