Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.25 / $63.25 / $63.25	Facility		$63.25	$63.25	$63.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $63.25 / $63.25	Professional		$52.71	$63.25	$63.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.64 / $334.01 / $608.34	Facility		$167.64	$334.01	$608.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.22 / $110.76 / $149.53	Professional		$105.22	$110.76	$149.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.27 / $71.98 / $72.42	Facility		$70.27	$71.98	$72.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.61 / $88.61 / $88.61	Professional		$88.61	$88.61	$88.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.96 / $87.96 / $87.96	Facility		$87.96	$87.96	$87.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $87.96 / $128.25	Professional		$79.27	$87.96	$128.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $63.25 / $80.04 / $80.04	Facility		$63.25	$80.04	$80.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $80.04 / $124.56	Professional		$63.25	$80.04	$124.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $82.13 / $82.13	Professional		$75.00	$82.13	$82.13
United Facility/Professional Professional Modifier Low / Median / High Price $41.15 / $52.95 / $79.27	Professional		$41.15	$52.95	$79.27