Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.85 / $51.85 / $51.85	Facility		$51.85	$51.85	$51.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.21 / $51.85 / $51.85	Professional		$43.21	$51.85	$51.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.43 / $273.82 / $498.71	Facility		$137.43	$273.82	$498.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.26 / $90.80 / $122.58	Professional		$86.26	$90.80	$122.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.56 / $59.02 / $59.33	Facility		$57.56	$59.02	$59.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.64 / $72.64 / $72.64	Professional		$72.64	$72.64	$72.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.66 / $50.66 / $50.66	Facility		$50.66	$50.66	$50.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.66 / $50.66 / $105.38	Professional		$50.66	$50.66	$105.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $51.85 / $65.61 / $65.61	Facility		$51.85	$65.61	$65.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $65.61 / $95.34	Professional		$48.40	$65.61	$95.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $67.19 / $77.26	Professional		$55.09	$67.19	$77.26
United Facility/Professional Professional Modifier Low / Median / High Price $33.71 / $43.40 / $64.98	Professional		$33.71	$43.40	$64.98