Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Facility		$70.00	$70.00	$70.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Professional		$70.00	$70.00	$70.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.88 / $52.82 / $65.36	Facility		$37.88	$52.82	$65.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.36 / $57.94 / $65.36	Professional		$47.36	$57.94	$65.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Facility		$70.00	$70.00	$70.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $73.50	Professional		$70.00	$70.00	$73.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $265.00 / $265.00 / $265.00	Professional		$265.00	$265.00	$265.00