Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.63 / $44.63 / $44.63	Facility		$44.63	$44.63	$44.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $44.63 / $44.63	Professional		$37.07	$44.63	$44.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.27 / $235.64 / $429.18	Facility		$118.27	$235.64	$429.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $78.14 / $105.49	Professional		$74.23	$78.14	$105.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.58 / $50.79 / $51.07	Facility		$49.58	$50.79	$51.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.51 / $62.51 / $62.51	Professional		$62.51	$62.51	$62.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.62 / $43.62 / $43.62	Facility		$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $43.62 / $90.75	Professional		$43.62	$43.62	$90.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $44.63 / $56.48 / $56.48	Facility		$44.63	$56.48	$56.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $56.48 / $82.04	Professional		$44.63	$56.48	$82.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.14 / $57.82 / $66.49	Professional		$49.14	$57.82	$66.49
United Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $36.70 / $55.93	Professional		$27.27	$36.70	$55.93