Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $19.95 / $19.95	Facility		$19.00	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $19.57 / $116.68	Professional		$19.00	$19.57	$116.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.25 / $36.25 / $36.25	Professional		$36.25	$36.25	$36.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.49 / $42.82 / $48.11	Facility		$38.49	$42.82	$48.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.68 / $48.11 / $58.65	Professional		$40.68	$48.11	$58.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.57 / $18.68 / $18.68	Facility		$18.57	$18.68	$18.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $18.68 / $55.40	Professional		$18.57	$18.68	$55.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $27.69 / $82.67	Professional		$21.00	$27.69	$82.67
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $24.95 / $24.95	Facility		$19.00	$24.95	$24.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $20.00 / $31.18	Professional		$19.00	$20.00	$31.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $57.56 / $72.92	Professional		$47.51	$57.56	$72.92