Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.22 / $27.22 / $27.22	Facility		$27.22	$27.22	$27.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $27.22 / $27.22	Professional		$23.16	$27.22	$27.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.14 / $143.72 / $261.77	Facility		$72.14	$143.72	$261.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $47.66 / $64.34	Professional		$45.28	$47.66	$64.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.98 / $30.98 / $30.98	Facility		$30.98	$30.98	$30.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $38.13 / $38.13	Professional		$38.13	$38.13	$38.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.78 / $29.78 / $29.78	Facility		$29.78	$29.78	$29.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.77 / $29.78 / $55.13	Professional		$29.77	$29.78	$55.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $27.22 / $34.44 / $34.44	Facility		$27.22	$34.44	$34.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $34.44 / $51.06	Professional		$27.22	$34.44	$51.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.92 / $35.27 / $40.56	Professional		$28.92	$35.27	$40.56
United Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $23.77 / $36.64	Professional		$19.80	$23.77	$36.64