Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.41 / $72.41 / $72.41	Facility		$72.41	$72.41	$72.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.35 / $72.41 / $72.41	Professional		$60.35	$72.41	$72.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.92 / $382.38 / $696.44	Facility		$191.92	$382.38	$696.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.46 / $126.80 / $171.18	Professional		$120.46	$126.80	$171.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $82.42 / $82.88	Facility		$80.45	$82.42	$82.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.44 / $101.44 / $101.44	Professional		$101.44	$101.44	$101.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.70 / $100.70 / $100.70	Facility		$100.70	$100.70	$100.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $100.70 / $163.16	Professional		$85.60	$100.70	$163.16
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $72.41 / $91.63 / $91.63	Facility		$72.41	$91.63	$91.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $72.41 / $91.63 / $142.61	Professional		$72.41	$91.63	$142.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $157.70 / $157.70	Professional		$75.00	$157.70	$157.70
United Facility/Professional Professional Modifier Low / Median / High Price $47.11 / $60.62 / $91.97	Professional		$47.11	$60.62	$91.97