Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.86 / $28.86 / $28.86	Facility		$28.86	$28.86	$28.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.98 / $28.86 / $28.86	Professional		$23.98	$28.86	$28.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.48 / $152.38 / $277.52	Facility		$76.48	$152.38	$277.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $50.53 / $68.22	Professional		$48.00	$50.53	$68.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.07 / $32.84 / $33.04	Facility		$32.07	$32.84	$33.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.42 / $40.42 / $40.42	Professional		$40.42	$40.42	$40.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.84 / $33.84 / $33.84	Facility		$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.67 / $33.84 / $58.50	Professional		$25.67	$33.84	$58.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $28.86 / $36.53 / $36.53	Facility		$28.86	$36.53	$36.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.24 / $36.53 / $53.05	Professional		$28.24	$36.53	$53.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.78 / $37.39 / $42.99	Professional		$31.78	$37.39	$42.99
United Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $23.74 / $36.18	Professional		$17.64	$23.74	$36.18