Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.15 / $28.15 / $28.15	Facility		$28.15	$28.15	$28.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $28.15 / $37.17	Professional		$25.35	$28.15	$37.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.54 / $232.20 / $422.91	Facility		$116.54	$232.20	$422.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.15 / $77.00 / $103.95	Professional		$73.15	$77.00	$103.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.86 / $58.86 / $58.86	Facility		$58.86	$58.86	$58.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.68 / $49.68 / $49.68	Facility		$49.68	$49.68	$49.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.68 / $49.68 / $62.27	Professional		$49.68	$49.68	$62.27
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $28.15 / $49.75 / $49.75	Facility		$28.15	$49.75	$49.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $49.75 / $62.86	Professional		$28.15	$49.75	$62.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $55.81 / $83.71	Professional		$30.00	$55.81	$83.71
United Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $32.92 / $54.75	Professional		$25.87	$32.92	$54.75