Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.22 / $42.22 / $42.22	Facility		$42.22	$42.22	$42.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $42.22 / $42.22	Professional		$34.72	$42.22	$42.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.90 / $222.94 / $406.05	Facility		$111.90	$222.94	$406.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $73.93 / $99.81	Professional		$70.23	$73.93	$99.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.03 / $48.05 / $50.74	Facility		$46.03	$48.05	$50.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.14 / $59.14 / $59.14	Professional		$59.14	$59.14	$59.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.25 / $37.25 / $37.25	Facility		$37.25	$37.25	$37.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $37.25 / $85.88	Professional		$37.25	$37.25	$85.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $42.22 / $53.43 / $53.43	Facility		$42.22	$53.43	$53.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $53.43 / $77.62	Professional		$38.04	$53.43	$77.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.86 / $54.71 / $62.91	Professional		$44.86	$54.71	$62.91
United Facility/Professional Professional Modifier Low / Median / High Price $24.34 / $35.35 / $49.18	Professional		$24.34	$35.35	$49.18