Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Facility		$25.00	$25.00	$25.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.50 / $67.50 / $67.50	Facility		$67.50	$67.50	$67.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.13 / $67.50 / $91.13	Professional		$64.13	$67.50	$91.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.66 / $19.66 / $28.08	Facility		$19.66	$19.66	$28.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.74 / $32.74 / $32.74	Facility		$32.74	$32.74	$32.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $32.74 / $33.72	Professional		$23.90	$32.74	$33.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Facility		$25.00	$25.00	$25.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $29.14	Professional		$25.00	$25.00	$29.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $30.00 / $43.71	Professional		$24.76	$30.00	$43.71
United Facility/Professional Professional Modifier Low / Median / High Price $88.94 / $88.94 / $88.94	Professional		$88.94	$88.94	$88.94