Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $123.03 / $199.53	Facility		$12.02	$123.03	$199.53
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $85.11 / $169.82 / $389.05	Facility	25	$85.11	$169.82	$389.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $16.98 / $112.20	Facility		$14.79	$16.98	$112.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $15.85 / $23.99	Facility		$10.96	$15.85	$23.99
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $120.23 / $204.17	Facility		$10.72	$120.23	$204.17
Health Alliance Plan Facility/Professional Facility Modifier 25 Low / Median / High Price $85.11 / $162.18 / $263.03	Facility	25	$85.11	$162.18	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $234.42	Facility		$87.10	$87.10	$234.42