Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.64 / $23.64 / $23.64	Facility		$23.64	$23.64	$23.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.61 / $23.64 / $23.64	Professional		$19.61	$23.64	$23.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $124.82 / $227.33	Facility		$62.64	$124.82	$227.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.32 / $41.39 / $55.88	Professional		$39.32	$41.39	$55.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.23 / $26.90 / $27.03	Facility		$26.23	$26.90	$27.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Professional		$33.11	$33.11	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.09 / $23.09 / $23.09	Facility		$23.09	$23.09	$23.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.09 / $23.09 / $48.00	Professional		$23.09	$23.09	$48.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $23.64 / $29.91 / $29.91	Facility		$23.64	$29.91	$29.91
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $23.12 / $29.91 / $43.45	Professional		$23.12	$29.91	$43.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.03 / $30.63 / $35.22	Professional		$26.03	$30.63	$35.22
United Facility/Professional Professional Modifier Low / Median / High Price $14.43 / $19.43 / $29.62	Professional		$14.43	$19.43	$29.62