Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.57 / $31.57 / $31.57	Facility		$31.57	$31.57	$31.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.99 / $31.57 / $32.67	Professional		$26.99	$31.57	$32.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.66 / $166.67 / $303.56	Facility		$83.66	$166.67	$303.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.51 / $55.27 / $74.61	Professional		$52.51	$55.27	$74.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.93 / $35.93 / $40.94	Facility		$35.93	$35.93	$40.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.22 / $44.22 / $44.22	Professional		$44.22	$44.22	$44.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $34.54 / $34.54	Facility		$34.54	$34.54	$34.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $34.54 / $64.13	Professional		$34.54	$34.54	$64.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $31.57 / $39.95 / $39.95	Facility		$31.57	$39.95	$39.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $39.95 / $58.03	Professional		$31.57	$39.95	$58.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.53 / $40.90 / $47.03	Professional		$33.53	$40.90	$47.03
United Facility/Professional Professional Modifier Low / Median / High Price $22.98 / $27.58 / $42.50	Professional		$22.98	$27.58	$42.50