Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $12.88 / $15.14	Facility		$12.88	$12.88	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $15.14 / $41.69	Professional		$10.00	$15.14	$41.69
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $25.12 / $44.67 / $44.67	Professional	25	$25.12	$44.67	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $16.22 / $23.44	Professional		$12.59	$16.22	$23.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $22.39 / $23.44	Facility		$19.05	$22.39	$23.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $23.99 / $23.99	Professional		$20.42	$23.99	$23.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $15.85 / $21.88	Facility		$12.02	$15.85	$21.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $17.78 / $33.11	Professional		$14.13	$17.78	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $19.50 / $19.50	Facility		$19.50	$19.50	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $17.78 / $40.74	Professional		$12.88	$17.78	$40.74
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $15.14 / $39.81	Facility		$12.88	$15.14	$39.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $15.14 / $27.54	Professional		$10.00	$15.14	$27.54
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $21.38 / $21.38 / $25.12	Professional	25	$21.38	$21.38	$25.12
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $19.50 / $19.50	Facility		$19.50	$19.50	$19.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $16.60 / $36.31	Professional		$12.30	$16.60	$36.31
United Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $13.80 / $16.98	Facility		$12.30	$13.80	$16.98
United Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $15.49 / $22.39	Professional		$12.02	$15.49	$22.39