Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.13 / $66.13 / $66.13	Facility		$66.13	$66.13	$66.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.97 / $66.13 / $68.34	Professional		$54.97	$66.13	$68.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $175.26 / $349.18 / $635.96	Facility		$175.26	$349.18	$635.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $115.79 / $156.32	Professional		$110.00	$115.79	$156.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.52 / $75.26 / $75.70	Facility		$73.52	$75.26	$75.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.63 / $92.63 / $92.63	Professional		$92.63	$92.63	$92.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.66 / $64.66 / $64.66	Facility		$64.66	$64.66	$64.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.89 / $64.66 / $134.25	Professional		$62.89	$64.66	$134.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $66.13 / $83.68 / $83.68	Facility		$66.13	$83.68	$83.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $62.19 / $83.68 / $121.57	Professional		$62.19	$83.68	$121.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.82 / $85.68 / $98.53	Professional		$72.82	$85.68	$98.53
United Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $54.38 / $82.88	Professional		$43.02	$54.38	$82.88