Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.71 / $32.71 / $32.71	Facility		$32.71	$32.71	$32.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.70 / $32.71 / $32.71	Professional		$23.70	$32.71	$32.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.03 / $129.55 / $235.95	Facility		$65.03	$129.55	$235.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.81 / $42.96 / $58.00	Professional		$40.81	$42.96	$58.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.92 / $27.92 / $27.92	Facility		$27.92	$27.92	$27.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $34.36 / $34.36	Professional		$34.36	$34.36	$34.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.81 / $25.81 / $25.81	Facility		$25.81	$25.81	$25.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.90 / $26.94 / $35.72	Professional		$22.90	$26.94	$35.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $31.05 / $31.05 / $32.71	Facility		$31.05	$31.05	$32.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.71 / $48.32	Professional		$26.17	$32.71	$48.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.55 / $26.94 / $36.52	Professional		$21.55	$26.94	$36.52
United Facility/Professional Professional Modifier Low / Median / High Price $14.26 / $20.17 / $30.75	Professional		$14.26	$20.17	$30.75