Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $8.91 / $489.78	Facility		$8.91	$8.91	$489.78
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $77.62 / $100.00 / $134.90	Facility	CQ	$77.62	$100.00	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $10.00 / $21.38	Professional		$7.08	$10.00	$21.38
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $7.24 / $28.18 / $28.84	Professional	CQ	$7.24	$28.18	$28.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $18.20 / $23.99	Facility		$12.88	$18.20	$23.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $11.75 / $11.75	Professional		$10.96	$11.75	$11.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $18.20 / $26.92	Facility		$13.80	$18.20	$26.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $11.48 / $13.18	Professional		$11.48	$11.48	$13.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $64.57	Facility		$53.70	$53.70	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $13.80 / $28.84	Professional		$9.77	$13.80	$28.84
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $19.05 / $52.48	Facility		$9.12	$19.05	$52.48
Health Alliance Plan Facility/Professional Facility Modifier CQ Low / Median / High Price $77.62 / $97.72 / $134.90	Facility	CQ	$77.62	$97.72	$134.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $13.80 / $23.99	Professional		$7.94	$13.80	$23.99
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $14.13 / $30.90	Professional		$9.77	$14.13	$30.90
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $12.02 / $14.79	Facility		$12.02	$12.02	$14.79
United Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $15.49 / $18.62	Professional		$10.72	$15.49	$18.62