Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.96 / $59.96 / $59.96	Facility		$59.96	$59.96	$59.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $57.50 / $59.96	Professional		$52.85	$57.50	$59.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.99 / $85.04 / $93.57	Facility		$62.99	$85.04	$93.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $74.70 / $83.07	Professional		$62.75	$74.70	$83.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $89.88 / $99.10	Professional		$62.75	$89.88	$99.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $59.96 / $59.96 / $59.96	Facility		$59.96	$59.96	$59.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $59.96 / $75.54	Professional		$52.85	$59.96	$75.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $147.60 / $147.60	Professional		$75.00	$147.60	$147.60