Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.88 / $69.88 / $69.88	Facility		$69.88	$69.88	$69.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $69.88 / $69.88	Professional		$64.05	$69.88	$69.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $368.99 / $672.05	Facility		$185.20	$368.99	$672.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.24 / $122.36 / $165.19	Professional		$116.24	$122.36	$165.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.15 / $79.53 / $87.59	Facility		$78.15	$79.53	$87.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.89 / $97.89 / $97.89	Professional		$97.89	$97.89	$97.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $73.43 / $73.43	Facility		$73.43	$73.43	$73.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $73.43 / $101.74	Professional		$69.23	$73.43	$101.74
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.88 / $88.42 / $88.42	Facility		$69.88	$88.42	$88.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.61 / $88.42 / $137.19	Professional		$69.61	$88.42	$137.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.96 / $90.55 / $104.13	Professional		$76.96	$90.55	$104.13
United Facility/Professional Professional Modifier Low / Median / High Price $45.90 / $58.63 / $87.57	Professional		$45.90	$58.63	$87.57