Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.12 / $64.12 / $64.12	Facility		$64.12	$64.12	$64.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.15 / $64.12 / $64.12	Professional		$53.15	$64.12	$64.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.94 / $338.59 / $616.69	Facility		$169.94	$338.59	$616.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.67 / $112.28 / $151.58	Professional		$106.67	$112.28	$151.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.63 / $65.91 / $72.98	Facility		$62.63	$65.91	$72.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.82 / $89.82 / $89.82	Professional		$89.82	$89.82	$89.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $60.21 / $60.21	Facility		$60.21	$60.21	$60.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.21 / $60.21 / $130.13	Professional		$60.21	$60.21	$130.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $64.12 / $81.15 / $81.15	Facility		$64.12	$81.15	$81.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $62.44 / $81.15 / $117.89	Professional		$62.44	$81.15	$117.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.13 / $83.09 / $95.55	Professional		$68.13	$83.09	$95.55
United Facility/Professional Professional Modifier Low / Median / High Price $40.06 / $53.68 / $76.75	Professional		$40.06	$53.68	$76.75