Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1.52 / $3.16 / $5.82	Facility		$1.52	$3.16	$5.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.99 / $1.04 / $1.40	Professional		$0.99	$1.04	$1.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $0.24 / $0.24	Professional		$0.24	$0.24	$0.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.55 / $22.55 / $22.55	Facility		$22.55	$22.55	$22.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $22.55 / $23.23	Professional		$19.17	$22.55	$23.23
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $3.03 / $3.03 / $5.00	Facility		$3.03	$3.03	$5.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $3.03 / $3.80 / $5.00	Professional		$3.03	$3.80	$5.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $30.00 / $75.00	Professional		$16.20	$30.00	$75.00