Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.01 / $28.01 / $28.01	Facility		$28.01	$28.01	$28.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.27 / $28.01 / $28.01	Professional		$23.27	$28.01	$28.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.23 / $147.88 / $269.35	Facility		$74.23	$147.88	$269.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.59 / $49.04 / $66.20	Professional		$46.59	$49.04	$66.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.12 / $31.88 / $32.06	Facility		$31.12	$31.88	$32.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $39.22 / $39.22	Professional		$39.22	$39.22	$39.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.38 / $27.38 / $27.38	Facility		$27.38	$27.38	$27.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $40.78 / $71.25	Professional		$19.98	$40.78	$71.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $28.01 / $35.45 / $35.45	Facility		$28.01	$35.45	$35.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.01 / $35.45 / $51.49	Professional		$28.01	$35.45	$51.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.84 / $36.29 / $41.73	Professional		$30.84	$36.29	$41.73
United Facility/Professional Professional Modifier Low / Median / High Price $17.11 / $23.03 / $34.65	Professional		$17.11	$23.03	$34.65