Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.63 / $19.63 / $19.63	Facility		$19.63	$19.63	$19.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.68 / $19.63 / $25.92	Professional		$17.68	$19.63	$25.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.70 / $156.81 / $285.60	Facility		$78.70	$156.81	$285.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.40 / $52.00 / $70.20	Professional		$49.40	$52.00	$70.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $48.59	Facility		$45.00	$45.00	$48.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.30 / $55.30 / $55.30	Professional		$55.30	$55.30	$55.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.06 / $30.06 / $30.06	Facility		$30.06	$30.06	$30.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $30.06 / $43.34	Professional		$17.13	$30.06	$43.34
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $19.63 / $34.70 / $34.70	Facility		$19.63	$34.70	$34.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $17.68 / $34.70 / $40.59	Professional		$17.68	$34.70	$40.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.56 / $17.13 / $30.00	Professional		$14.56	$17.13	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $18.04 / $22.95 / $38.88	Professional		$18.04	$22.95	$38.88