Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.50 / $17.50 / $99.94	Facility		$17.50	$17.50	$99.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.36 / $17.50 / $18.37	Professional		$10.36	$17.50	$18.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.34 / $69.30 / $131.71	Facility		$33.34	$69.30	$131.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.83 / $23.90 / $29.87	Professional		$21.83	$23.90	$29.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.98 / $31.02 / $37.92	Facility		$22.98	$31.02	$37.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.13 / $29.87 / $53.28	Professional		$24.13	$29.87	$53.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.73 / $11.73 / $33.28	Professional		$11.73	$11.73	$33.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $16.59 / $17.50 / $99.94	Facility		$16.59	$17.50	$99.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $16.44 / $16.59 / $27.58	Professional		$16.44	$16.59	$27.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $16.55 / $25.92	Professional		$14.40	$16.55	$25.92
United Facility/Professional Professional Modifier Low / Median / High Price $8.11 / $10.98 / $17.72	Professional		$8.11	$10.98	$17.72