Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.82 / $52.82 / $52.82	Facility		$52.82	$52.82	$52.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $52.82 / $52.82	Professional		$44.21	$52.82	$52.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.99 / $278.91 / $507.99	Facility		$139.99	$278.91	$507.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.87 / $92.49 / $124.86	Professional		$87.87	$92.49	$124.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $60.12 / $63.89	Facility		$58.60	$60.12	$63.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.98 / $73.98 / $73.98	Professional		$73.98	$73.98	$73.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.82 / $59.82 / $59.82	Facility		$59.82	$59.82	$59.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.82 / $59.82 / $107.25	Professional		$59.82	$59.82	$107.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.82 / $66.81 / $66.81	Facility		$52.82	$66.81	$66.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.82 / $66.81 / $102.72	Professional		$52.82	$66.81	$102.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.12 / $68.44 / $78.70	Professional		$56.12	$68.44	$78.70
United Facility/Professional Facility Modifier Low / Median / High Price $102.18 / $120.21 / $120.21	Facility		$102.18	$120.21	$120.21
United Facility/Professional Professional Modifier Low / Median / High Price $37.49 / $44.98 / $69.31	Professional		$37.49	$44.98	$69.31