Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $350.00 / $350.00	Professional		$350.00	$350.00	$350.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.51 / $79.89 / $146.19	Facility		$56.51	$79.89	$146.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $184.25 / $184.25 / $245.67	Facility		$184.25	$184.25	$245.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.53 / $257.95 / $257.95	Professional		$239.53	$257.95	$257.95
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $481.45 / $481.45 / $481.45	Facility		$481.45	$481.45	$481.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $481.45 / $481.45 / $553.66	Professional		$481.45	$481.45	$553.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $75.00	Professional		$30.00	$30.00	$75.00
United Facility/Professional Facility Modifier Low / Median / High Price $21.72 / $21.72 / $67.81	Facility		$21.72	$21.72	$67.81