Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.28 / $23.23 / $115.67	Facility		$22.28	$23.23	$115.67
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $23.40 / $51.66 / $99.90	Facility	CQ	$23.40	$51.66	$99.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $19.57 / $26.88	Professional		$14.40	$19.57	$26.88
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $19.46 / $21.66 / $587.05	Professional	CQ	$19.46	$21.66	$587.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.77 / $44.84 / $58.12	Facility		$31.77	$44.84	$58.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $63.00 / $90.00	Professional		$27.75	$63.00	$90.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $27.00 / $41.31	Facility		$15.00	$27.00	$41.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $31.67 / $35.83	Professional		$27.54	$31.67	$35.83
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 $20.66 / $42.74 / $111.17	Professional		$20.66	$42.74	$111.17
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $22.28 / $26.42 / $115.67	Facility		$22.28	$26.42	$115.67
Health Alliance Plan Facility/Professional Facility Modifier CQ Low / Median / High Price $23.40 / $63.21 / $142.27	Facility	CQ	$23.40	$63.21	$142.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $15.96 / $22.98 / $35.65	Professional		$15.96	$22.98	$35.65
Health Alliance Plan Facility/Professional Professional Modifier CQ Low / Median / High Price $19.14 / $21.66 / $587.05	Professional	CQ	$19.14	$21.66	$587.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.11 / $18.96 / $30.00	Professional		$16.11	$18.96	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $26.27 / $29.92	Professional		$22.33	$26.27	$29.92