Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.52 / $43.52 / $43.52	Facility		$43.52	$43.52	$43.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.27 / $43.52 / $43.52	Professional		$36.27	$43.52	$43.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.36 / $229.85 / $418.63	Facility		$115.36	$229.85	$418.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.41 / $76.22 / $102.90	Professional		$72.41	$76.22	$102.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.33 / $49.54 / $49.80	Facility		$48.33	$49.54	$49.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.98 / $60.98 / $60.98	Professional		$60.98	$60.98	$60.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.76 / $43.76 / $43.76	Facility		$43.76	$43.76	$43.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $63.36 / $110.63	Professional		$37.20	$63.36	$110.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $43.52 / $55.07 / $55.07	Facility		$43.52	$55.07	$55.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $55.07 / $80.03	Professional		$43.52	$55.07	$80.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $56.40 / $64.86	Professional		$47.94	$56.40	$64.86
United Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $36.43 / $54.54	Professional		$28.30	$36.43	$54.54