Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $42.87	Facility		$42.87	$42.87	$42.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $42.87 / $42.87	Professional		$35.61	$42.87	$42.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.63 / $226.38 / $412.31	Facility		$113.63	$226.38	$412.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.31 / $75.06 / $101.34	Professional		$71.31	$75.06	$101.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.63 / $48.80 / $49.06	Facility		$47.63	$48.80	$49.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.06 / $60.06 / $60.06	Professional		$60.06	$60.06	$60.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.91 / $41.91 / $41.91	Facility		$41.91	$41.91	$41.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $62.42 / $108.75	Professional		$30.59	$62.42	$108.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $54.25 / $54.25	Facility		$42.87	$54.25	$54.25
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $42.87 / $54.25 / $84.43	Professional		$42.87	$54.25	$84.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Facility Modifier Low / Median / High Price $76.02 / $89.43 / $89.43	Facility		$76.02	$89.43	$89.43
United Facility/Professional Professional Modifier Low / Median / High Price $26.20 / $35.63 / $53.73	Professional		$26.20	$35.63	$53.73