Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.14 / $42.14 / $42.14	Facility		$42.14	$42.14	$42.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $42.14 / $42.14	Professional		$35.95	$42.14	$42.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.70 / $222.55 / $405.34	Facility		$111.70	$222.55	$405.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.11 / $73.80 / $99.63	Professional		$70.11	$73.80	$99.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.66 / $47.66 / $47.97	Facility		$47.66	$47.66	$47.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $59.04 / $59.04	Professional		$59.04	$59.04	$59.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.81 / $45.81 / $45.81	Facility		$45.81	$45.81	$45.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.81 / $45.81 / $85.50	Professional		$45.81	$45.81	$85.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $42.14 / $53.32 / $53.32	Facility		$42.14	$53.32	$53.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $53.32 / $81.05	Professional		$42.14	$53.32	$81.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.78 / $54.61 / $62.80	Professional		$44.78	$54.61	$62.80
United Facility/Professional Professional Modifier Low / Median / High Price $30.48 / $36.58 / $56.36	Professional		$30.48	$36.58	$56.36