Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.20 / $855.90 / $876.15	Facility		$4.20	$855.90	$876.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3.22 / $4.20 / $4.72	Professional		$3.22	$4.20	$4.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6.36 / $13.57 / $25.79	Facility		$6.36	$13.57	$25.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.26 / $4.68 / $5.85	Professional		$4.26	$4.68	$5.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.01 / $6.75 / $8.27	Facility		$5.01	$6.75	$8.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5.32 / $6.51 / $10.98	Professional		$5.32	$6.51	$10.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.30 / $1.30 / $9.00	Professional		$1.30	$1.30	$9.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $5.29 / $855.90 / $876.15	Facility		$5.29	$855.90	$876.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $4.20 / $5.56 / $7.22	Professional		$4.20	$5.56	$7.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $1,500.00	Professional		$30.00	$75.00	$1,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $2.27 / $3.55 / $6.53	Professional		$2.27	$3.55	$6.53