Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.86 / $32.86 / $32.86	Facility		$32.86	$32.86	$32.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.11 / $32.86 / $32.86	Professional		$28.11	$32.86	$32.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.12 / $173.58 / $316.14	Facility		$87.12	$173.58	$316.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $57.56 / $77.70	Professional		$54.68	$57.56	$77.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.40 / $38.82 / $39.72	Facility		$37.40	$38.82	$39.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.05 / $46.05 / $46.05	Professional		$46.05	$46.05	$46.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.97 / $35.97 / $35.97	Facility		$35.97	$35.97	$35.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $35.97 / $66.75	Professional		$35.97	$35.97	$66.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $32.86 / $41.60 / $41.60	Facility		$32.86	$41.60	$41.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $41.60 / $66.15	Professional		$32.86	$41.60	$66.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.92 / $42.59 / $48.97	Professional		$34.92	$42.59	$48.97
United Facility/Professional Professional Modifier Low / Median / High Price $23.93 / $28.72 / $44.25	Professional		$23.93	$28.72	$44.25