Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $90.00	Professional		$50.00	$50.00	$90.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $94.13 / $127.31	Professional		$49.92	$94.13	$127.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $39.49	Facility		$30.00	$30.00	$39.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47,999.52 / $47,999.52 / $47,999.52	Professional		$47,999.52	$47,999.52	$47,999.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $60.00	Facility		$45.00	$45.00	$60.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.91 / $55.00 / $68.75	Professional		$41.91	$55.00	$68.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.65	Professional		$30.00	$30.00	$55.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $33.74 / $1,500.00	Professional		$30.00	$33.74	$1,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $45.00	Professional		$40.00	$40.00	$45.00