Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $15.75 / $15.75	Facility		$15.00	$15.75	$15.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.32 / $15.00 / $472.50	Professional		$14.32	$15.00	$472.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.06 / $18.82 / $21.65	Facility		$15.06	$18.82	$21.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.06 / $19.96 / $24.90	Professional		$15.06	$19.96	$24.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.02 / $17.13 / $17.13	Facility		$17.02	$17.13	$17.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $17.13 / $37.59	Professional		$17.02	$17.13	$37.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $15.45 / $40.44	Professional		$10.00	$15.45	$40.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $25.00 / $25.00	Facility		$15.00	$25.00	$25.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $14.51 / $15.00 / $26.58	Professional		$14.51	$15.00	$26.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Facility Modifier Low / Median / High Price $67.43 / $67.43 / $210.59	Facility		$67.43	$67.43	$210.59
United Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $39.77 / $50.93	Professional		$34.29	$39.77	$50.93