Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.87 / $28.87 / $28.87	Facility		$28.87	$28.87	$28.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.06 / $28.87 / $28.87	Professional		$24.06	$28.87	$28.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.48 / $152.41 / $277.58	Facility		$76.48	$152.41	$277.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.01 / $50.54 / $68.23	Professional		$48.01	$50.54	$68.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.08 / $32.85 / $33.04	Facility		$32.08	$32.85	$33.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $40.43 / $40.43	Professional		$40.43	$40.43	$40.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.14 / $40.14 / $40.14	Facility		$40.14	$40.14	$40.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.93 / $40.14 / $58.50	Professional		$31.93	$40.14	$58.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $28.87 / $36.54 / $36.54	Facility		$28.87	$36.54	$36.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $36.54 / $56.85	Professional		$28.87	$36.54	$56.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $18.78 / $24.17 / $36.19	Professional		$18.78	$24.17	$36.19