Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.34 / $43.34 / $43.34	Facility		$43.34	$43.34	$43.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.03 / $43.34 / $57.22	Professional		$39.03	$43.34	$57.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $227.04 / $456.36 / $839.08	Facility		$227.04	$456.36	$839.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.50 / $150.00 / $202.50	Professional		$142.50	$150.00	$202.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.96 / $89.96 / $104.13	Facility		$89.96	$89.96	$104.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.53 / $59.53 / $59.53	Professional		$59.53	$59.53	$59.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.13 / $47.13 / $47.13	Facility		$47.13	$47.13	$47.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.06 / $47.13 / $115.14	Professional		$44.06	$47.13	$115.14
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $43.34 / $76.59 / $76.59	Facility		$43.34	$76.59	$76.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $74.06 / $96.77	Professional		$43.34	$74.06	$96.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $44.06 / $66.09	Professional		$30.00	$44.06	$66.09
United Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $50.67 / $83.78	Professional		$39.83	$50.67	$83.78