Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $194.98	Professional		$70.79	$70.79	$194.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $48.98 / $57.54	Facility		$30.20	$48.98	$57.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $43.65 / $63.10	Professional		$38.02	$43.65	$63.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $177.83	Professional		$70.79	$70.79	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03