Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.38 / $20.38 / $20.38	Facility		$20.38	$20.38	$20.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $20.38 / $23.06	Professional		$16.98	$20.38	$23.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.94 / $119.42 / $217.50	Facility		$59.94	$119.42	$217.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $39.60 / $53.46	Professional		$37.61	$39.60	$53.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.74 / $25.74 / $32.90	Facility		$25.74	$25.74	$32.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.38 / $27.38 / $27.38	Professional		$27.38	$27.38	$27.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.22 / $22.22 / $22.22	Facility		$22.22	$22.22	$22.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $22.22 / $31.77	Professional		$22.22	$22.22	$31.77
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $17.39 / $17.39 / $20.38	Facility		$17.39	$17.39	$20.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $20.38 / $39.60	Professional		$17.39	$20.38	$39.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.01 / $29.43 / $36.78	Professional		$25.01	$29.43	$36.78
United Facility/Professional Professional Modifier Low / Median / High Price $15.38 / $19.37 / $28.58	Professional		$15.38	$19.37	$28.58