Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.99 / $32.99 / $32.99	Facility		$32.99	$32.99	$32.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.21 / $32.99 / $35.17	Professional		$28.21	$32.99	$35.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.44 / $174.21 / $317.30	Facility		$87.44	$174.21	$317.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.88 / $57.77 / $77.98	Professional		$54.88	$57.77	$77.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.54 / $37.54 / $37.54	Facility		$37.54	$37.54	$37.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $46.22 / $46.22	Professional		$46.22	$46.22	$46.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.36 / $37.36 / $37.36	Facility		$37.36	$37.36	$37.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $37.36 / $67.13	Professional		$37.36	$37.36	$67.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $32.99 / $41.75 / $41.75	Facility		$32.99	$41.75	$41.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $32.99 / $41.75 / $64.75	Professional		$32.99	$41.75	$64.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.05 / $42.75 / $49.16	Professional		$35.05	$42.75	$49.16
United Facility/Professional Professional Modifier Low / Median / High Price $24.02 / $28.82 / $44.41	Professional		$24.02	$28.82	$44.41