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
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $5.92 / $5.92 / $5.92	Professional		$5.92	$5.92	$5.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6.68 / $13.30 / $24.22	Facility		$6.68	$13.30	$24.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.41 / $5.95	Professional		$4.19	$4.41	$5.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.64 / $3.64 / $3.64	Facility		$3.64	$3.64	$3.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5.92 / $5.92 / $5.92	Professional		$5.92	$5.92	$5.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4.12 / $4.12 / $4.12	Facility		$4.12	$4.12	$4.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.36 / $4.12 / $6.00	Professional		$2.36	$4.12	$6.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1.94 / $1.94 / $5.00	Facility		$1.94	$1.94	$5.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1.94 / $3.80 / $6.46	Professional		$1.94	$3.80	$6.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $1,500.00	Professional		$30.00	$30.00	$1,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $0.22 / $2.93 / $5.43	Professional		$0.22	$2.93	$5.43