Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.89 / $10.89 / $37.88	Facility		$10.89	$10.89	$37.88
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $12.34 / $29.92 / $96.87	Facility	CQ	$12.34	$29.92	$96.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.63 / $10.89 / $14.58	Professional		$7.63	$10.89	$14.58
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $9.16 / $41.15 / $41.15	Professional	CQ	$9.16	$41.15	$41.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.35 / $21.66 / $28.08	Facility		$15.35	$21.66	$28.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $63.00 / $90.00	Professional		$13.49	$63.00	$90.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.32 / $15.00 / $22.05	Facility		$13.32	$15.00	$22.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.21 / $15.19 / $17.32	Professional		$13.21	$15.19	$17.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.50 / $65.00 / $65.00	Facility		$53.50	$65.00	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.01 / $20.07 / $111.17	Professional		$10.01	$20.07	$111.17
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $10.89 / $10.89 / $37.88	Facility		$10.89	$10.89	$37.88
Health Alliance Plan Facility/Professional Facility Modifier CQ Low / Median / High Price $12.34 / $29.92 / $96.87	Facility	CQ	$12.34	$29.92	$96.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $8.48 / $11.43 / $16.84	Professional		$8.48	$11.43	$16.84
Health Alliance Plan Facility/Professional Professional Modifier CQ Low / Median / High Price $9.16 / $41.15 / $41.15	Professional	CQ	$9.16	$41.15	$41.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.16 / $9.16 / $75.00	Professional		$9.16	$9.16	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $10.88 / $12.51 / $14.46	Professional		$10.88	$12.51	$14.46