Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.64 / $58.64 / $58.64	Facility		$58.64	$58.64	$58.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $58.64 / $58.64	Professional		$48.72	$58.64	$58.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.43 / $309.67 / $564.01	Facility		$155.43	$309.67	$564.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.56 / $102.69 / $138.63	Professional		$97.56	$102.69	$138.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.16 / $66.75 / $67.12	Facility		$65.16	$66.75	$67.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $82.15 / $82.15 / $82.15	Professional		$82.15	$82.15	$82.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.65 / $69.65 / $69.65	Facility		$69.65	$69.65	$69.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.75 / $69.65 / $118.88	Professional		$51.75	$69.65	$118.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $58.64 / $74.20 / $74.20	Facility		$58.64	$74.20	$74.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $57.38 / $74.20 / $107.82	Professional		$57.38	$74.20	$107.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $75.98 / $87.38	Professional		$64.59	$75.98	$87.38
United Facility/Professional Professional Modifier Low / Median / High Price $35.84 / $48.23 / $73.50	Professional		$35.84	$48.23	$73.50