Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.60 / $44.60 / $44.60	Facility		$44.60	$44.60	$44.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.17 / $44.60 / $44.60	Professional		$37.17	$44.60	$44.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.19 / $235.49 / $428.90	Facility		$118.19	$235.49	$428.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.19 / $78.09 / $105.42	Professional		$74.19	$78.09	$105.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.55 / $50.76 / $51.03	Facility		$49.55	$50.76	$51.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.47 / $62.47 / $62.47	Professional		$62.47	$62.47	$62.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.01 / $62.01 / $62.01	Facility		$62.01	$62.01	$62.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.89 / $62.01 / $90.38	Professional		$55.89	$62.01	$90.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $44.60 / $56.43 / $56.43	Facility		$44.60	$56.43	$56.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $44.60 / $56.43 / $87.83	Professional		$44.60	$56.43	$87.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $37.78 / $75.00	Professional		$37.78	$37.78	$75.00
United Facility/Professional Facility Modifier Low / Median / High Price $46.00 / $46.42 / $52.45	Facility		$46.00	$46.42	$52.45
United Facility/Professional Professional Modifier Low / Median / High Price $29.01 / $37.33 / $55.89	Professional		$29.01	$37.33	$55.89