Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.82 / $57.82 / $57.82	Facility		$57.82	$57.82	$57.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.21 / $57.82 / $57.82	Professional		$49.21	$57.82	$57.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.25 / $305.33 / $556.11	Facility		$153.25	$305.33	$556.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.19 / $101.25 / $136.69	Professional		$96.19	$101.25	$136.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $65.81 / $75.98	Facility		$65.81	$65.81	$75.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $81.00 / $81.00	Professional		$81.00	$81.00	$81.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.22 / $66.22 / $66.22	Facility		$66.22	$66.22	$66.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.22 / $66.22 / $117.38	Professional		$66.22	$66.22	$117.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $57.82 / $73.16 / $73.16	Facility		$57.82	$73.16	$73.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $57.82 / $73.16 / $116.43	Professional		$57.82	$73.16	$116.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $74.93 / $86.16	Professional		$61.44	$74.93	$86.16
United Facility/Professional Professional Modifier Low / Median / High Price $42.10 / $50.51 / $77.83	Professional		$42.10	$50.51	$77.83