Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.50 / $52.50 / $52.50	Facility		$52.50	$52.50	$52.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.38 / $52.50 / $134.76	Professional		$44.38	$52.50	$134.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.13 / $277.22 / $504.92	Facility		$139.13	$277.22	$504.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.33 / $91.93 / $124.11	Professional		$87.33	$91.93	$124.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.34 / $59.75 / $60.10	Facility		$58.34	$59.75	$60.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.54 / $73.54 / $73.54	Professional		$73.54	$73.54	$73.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Facility		$61.54	$61.54	$61.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $61.54 / $106.50	Professional		$61.54	$61.54	$106.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.50 / $66.43 / $66.43	Facility		$52.50	$66.43	$66.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $49.38 / $66.43 / $110.31	Professional		$49.38	$66.43	$110.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.82 / $68.03 / $78.23	Professional		$57.82	$68.03	$78.23
United Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $43.17 / $65.79	Professional		$32.08	$43.17	$65.79