Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.85 / $52.85 / $52.85	Facility		$52.85	$52.85	$52.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.78 / $52.85 / $52.85	Professional		$44.78	$52.85	$52.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.08 / $279.08 / $508.32	Facility		$140.08	$279.08	$508.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.92 / $92.55 / $124.94	Professional		$87.92	$92.55	$124.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.61 / $59.36 / $60.16	Facility		$54.61	$59.36	$60.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.04 / $74.04 / $74.04	Professional		$74.04	$74.04	$74.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.87 / $59.87 / $59.87	Facility		$59.87	$59.87	$59.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.87 / $59.87 / $107.25	Professional		$59.87	$59.87	$107.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.85 / $66.88 / $66.88	Facility		$52.85	$66.88	$66.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $49.84 / $66.88 / $97.17	Professional		$49.84	$66.88	$97.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $68.48 / $78.76	Professional		$56.16	$68.48	$78.76
United Facility/Professional Professional Modifier Low / Median / High Price $34.93 / $44.25 / $64.59	Professional		$34.93	$44.25	$64.59