Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.32 / $20.32 / $20.32	Facility		$20.32	$20.32	$20.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.64 / $20.32 / $21.34	Professional		$11.64	$20.32	$21.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.93 / $99.61 / $189.32	Facility		$47.93	$99.61	$189.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.38 / $34.35 / $42.94	Professional		$31.38	$34.35	$42.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.19 / $34.01 / $41.56	Facility		$25.19	$34.01	$41.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.45 / $32.75 / $58.40	Professional		$26.45	$32.75	$58.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $15.09 / $36.56	Professional		$15.09	$15.09	$36.56
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $13.18 / $20.32	Facility		$13.18	$13.18	$20.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $15.15 / $30.22	Professional		$13.18	$15.15	$30.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.15 / $30.00 / $75.00	Professional		$24.15	$30.00	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $10.16 / $11.64 / $19.39	Professional		$10.16	$11.64	$19.39