Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.76 / $15.76 / $15.76	Facility		$15.76	$15.76	$15.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.53 / $15.76 / $15.76	Professional		$8.53	$15.76	$15.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.33 / $62.42 / $113.69	Facility		$31.33	$62.42	$113.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.67 / $20.70 / $27.95	Professional		$19.67	$20.70	$27.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.46 / $13.46 / $13.46	Facility		$13.46	$13.46	$13.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $16.55 / $16.55	Professional		$16.55	$16.55	$16.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8.94 / $12.44 / $12.44	Facility		$8.94	$12.44	$12.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.94 / $12.81 / $17.21	Professional		$8.94	$12.81	$17.21
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $14.97 / $14.97 / $15.76	Facility		$14.97	$14.97	$15.76
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $12.45 / $15.76 / $21.73	Professional		$12.45	$15.76	$21.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $13.11 / $17.60	Professional		$10.48	$13.11	$17.60
United Facility/Professional Professional Modifier Low / Median / High Price $6.87 / $9.56 / $14.63	Professional		$6.87	$9.56	$14.63