Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.84 / $33.84 / $33.84	Facility		$33.84	$33.84	$33.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.93 / $33.84 / $38.40	Professional		$28.93	$33.84	$38.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.68 / $178.67 / $325.42	Facility		$89.68	$178.67	$325.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.29 / $59.25 / $79.98	Professional		$56.29	$59.25	$79.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.51 / $38.51 / $50.58	Facility		$38.51	$38.51	$50.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $47.40 / $47.40	Professional		$47.40	$47.40	$47.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.03 / $37.03 / $37.03	Facility		$37.03	$37.03	$37.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.03 / $37.03 / $68.63	Professional		$37.03	$37.03	$68.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $33.84 / $42.83 / $42.83	Facility		$33.84	$42.83	$42.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $33.84 / $42.83 / $65.41	Professional		$33.84	$42.83	$65.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.27 / $43.85 / $54.81	Professional		$37.27	$43.85	$54.81
United Facility/Professional Professional Modifier Low / Median / High Price $24.64 / $29.56 / $45.56	Professional		$24.64	$29.56	$45.56