Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.26 / $19.26 / $19.26	Facility		$19.26	$19.26	$19.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $19.26 / $25.43	Professional		$17.35	$19.26	$25.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.81 / $180.94 / $329.54	Facility		$90.81	$180.94	$329.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $60.00 / $81.00	Professional		$57.00	$60.00	$81.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.59 / $48.59 / $70.20	Facility		$48.59	$48.59	$70.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.29 / $30.29 / $30.29	Facility		$30.29	$30.29	$30.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.52 / $30.29 / $58.03	Professional		$22.52	$30.29	$58.03
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $19.26 / $34.04 / $34.04	Facility		$19.26	$34.04	$34.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.26 / $32.92 / $43.01	Professional		$19.26	$32.92	$43.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $22.52 / $33.78	Professional		$19.14	$22.52	$33.78
United Facility/Professional Professional Modifier Low / Median / High Price $15.44 / $22.52 / $37.53	Professional		$15.44	$22.52	$37.53