Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.56 / $54.56 / $54.56	Facility		$54.56	$54.56	$54.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.01 / $54.56 / $55.55	Professional		$50.01	$54.56	$55.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.61 / $288.11 / $524.74	Facility		$144.61	$288.11	$524.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $95.54 / $128.97	Professional		$90.76	$95.54	$128.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $62.10 / $65.98	Facility		$62.10	$62.10	$65.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $76.43 / $76.43 / $76.43	Professional		$76.43	$76.43	$76.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.81 / $61.81 / $61.81	Facility		$61.81	$61.81	$61.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.05 / $61.81 / $79.44	Professional		$54.05	$61.81	$79.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $54.56 / $69.03 / $69.03	Facility		$54.56	$69.03	$69.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $54.56 / $69.03 / $107.46	Professional		$54.56	$69.03	$107.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.97 / $70.70 / $81.30	Professional		$57.97	$70.70	$81.30
United Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $45.67 / $68.38	Professional		$39.72	$45.67	$68.38