Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.13 / $69.13 / $69.13	Facility		$69.13	$69.13	$69.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.42 / $69.13 / $69.13	Professional		$57.42	$69.13	$69.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.23 / $365.07 / $664.91	Facility		$183.23	$365.07	$664.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.01 / $121.06 / $163.43	Professional		$115.01	$121.06	$163.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.80 / $78.69 / $79.09	Facility		$76.80	$78.69	$79.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $96.85 / $96.85	Professional		$96.85	$96.85	$96.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.56 / $67.56 / $67.56	Facility		$67.56	$67.56	$67.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $67.56 / $140.25	Professional		$67.56	$67.56	$140.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.13 / $87.49 / $87.49	Facility		$69.13	$87.49	$87.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $87.49 / $127.11	Professional		$67.56	$87.49	$127.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.45 / $89.58 / $103.01	Professional		$73.45	$89.58	$103.01
United Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $56.85 / $86.65	Professional		$44.96	$56.85	$86.65