Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.88 / $63.88 / $63.88	Facility		$63.88	$63.88	$63.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.06 / $63.88 / $63.88	Professional		$53.06	$63.88	$63.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.29 / $337.29 / $614.32	Facility		$169.29	$337.29	$614.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.26 / $111.85 / $151.00	Professional		$106.26	$111.85	$151.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.95 / $72.70 / $73.12	Facility		$70.95	$72.70	$73.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.48 / $89.48 / $89.48	Professional		$89.48	$89.48	$89.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.72 / $66.72 / $66.72	Facility		$66.72	$66.72	$66.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.72 / $66.72 / $129.75	Professional		$66.72	$66.72	$129.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $63.88 / $80.83 / $80.83	Facility		$63.88	$80.83	$80.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $62.52 / $80.83 / $117.44	Professional		$62.52	$80.83	$117.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.35 / $82.77 / $95.18	Professional		$70.35	$82.77	$95.18
United Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $52.53 / $80.05	Professional		$39.04	$52.53	$80.05