Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.29 / $69.29 / $69.29	Facility		$69.29	$69.29	$69.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $69.29 / $77.87	Professional		$63.52	$69.29	$77.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.64 / $365.88 / $666.39	Facility		$183.64	$365.88	$666.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $121.33 / $163.80	Professional		$115.26	$121.33	$163.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.11 / $78.86 / $97.15	Facility		$78.11	$78.86	$97.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.06 / $97.06 / $97.06	Professional		$97.06	$97.06	$97.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $75.09 / $75.09	Facility		$75.09	$75.09	$75.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.09 / $75.09 / $140.63	Professional		$75.09	$75.09	$140.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.29 / $87.69 / $87.69	Facility		$69.29	$87.69	$87.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.29 / $87.69 / $127.39	Professional		$69.29	$87.69	$127.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.61 / $89.78 / $103.24	Professional		$73.61	$89.78	$103.24
United Facility/Professional Professional Modifier Low / Median / High Price $46.94 / $59.42 / $86.85	Professional		$46.94	$59.42	$86.85