Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.36 / $68.36 / $68.36	Facility		$68.36	$68.36	$68.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.66 / $68.36 / $73.84	Professional		$62.66	$68.36	$73.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.18 / $360.97 / $657.44	Facility		$181.18	$360.97	$657.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.72 / $119.70 / $161.60	Professional		$113.72	$119.70	$161.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.81 / $78.27 / $84.54	Facility		$77.81	$78.27	$84.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.76 / $95.76 / $95.76	Professional		$95.76	$95.76	$95.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $84.33 / $84.33	Facility		$84.33	$84.33	$84.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.70 / $84.33 / $99.52	Professional		$67.70	$84.33	$99.52
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $68.36 / $86.48 / $86.48	Facility		$68.36	$86.48	$86.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $68.36 / $86.48 / $125.68	Professional		$68.36	$86.48	$125.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.63 / $88.58 / $101.86	Professional		$72.63	$88.58	$101.86
United Facility/Professional Professional Modifier Low / Median / High Price $44.51 / $56.85 / $85.65	Professional		$44.51	$56.85	$85.65