Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.24 / $26.24 / $26.24	Facility		$26.24	$26.24	$26.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.82 / $26.24 / $26.24	Professional		$21.82	$26.24	$26.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.55 / $138.57 / $252.38	Facility		$69.55	$138.57	$252.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.95 / $62.03	Professional		$43.65	$45.95	$62.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.17 / $29.87 / $30.04	Facility		$29.17	$29.87	$30.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $36.76 / $36.76	Professional		$36.76	$36.76	$36.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.10 / $27.10 / $27.10	Facility		$27.10	$27.10	$27.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.14 / $27.10 / $53.25	Professional		$23.14	$27.10	$53.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $26.24 / $33.21 / $33.21	Facility		$26.24	$33.21	$33.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $24.68 / $33.21 / $48.24	Professional		$24.68	$33.21	$48.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $34.00 / $39.10	Professional		$27.88	$34.00	$39.10
United Facility/Professional Professional Modifier Low / Median / High Price $16.04 / $21.58 / $32.89	Professional		$16.04	$21.58	$32.89