Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.40 / $104.40 / $104.40	Facility		$104.40	$104.40	$104.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $104.40 / $104.40	Professional		$104.40	$104.40	$104.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $464.63	Facility		$354.81	$354.81	$464.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.44 / $91.91 / $130.61	Professional		$7.44	$91.91	$130.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.63 / $131.63 / $131.63	Facility		$131.63	$131.63	$131.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $104.40 / $104.40	Professional		$104.40	$104.40	$104.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00