Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.73 / $78.73 / $78.73	Facility		$78.73	$78.73	$78.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.61 / $78.73 / $78.73	Professional		$65.61	$78.73	$78.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.66 / $415.73 / $757.18	Facility		$208.66	$415.73	$757.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.97 / $137.86 / $186.11	Professional		$130.97	$137.86	$186.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.25 / $88.09 / $89.61	Facility		$79.25	$88.09	$89.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.29 / $110.29 / $110.29	Professional		$110.29	$110.29	$110.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.19 / $89.19 / $89.19	Facility		$89.19	$89.19	$89.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.19 / $89.19 / $159.75	Professional		$89.19	$89.19	$159.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $78.73 / $99.63 / $99.63	Facility		$78.73	$99.63	$99.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $99.63 / $144.75	Professional		$73.48	$99.63	$144.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.65 / $102.02 / $117.32	Professional		$83.65	$102.02	$117.32
United Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $65.91 / $98.68	Professional		$50.39	$65.91	$98.68