Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.11 / $17.93 / $201.88	Facility		$9.11	$17.93	$201.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $15.16 / $21.99	Professional		$7.76	$15.16	$21.99
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $22.54 / $22.54 / $22.54	Professional	25	$22.54	$22.54	$22.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.95 / $5.70 / $9.22	Professional	52	$3.95	$5.70	$9.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.94 / $16.22 / $16.22	Professional		$8.94	$16.22	$16.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.45 / $13.45 / $148.68	Facility		$13.45	$13.45	$148.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.53 / $14.12 / $18.16	Professional		$12.53	$14.12	$18.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $10.88 / $12.77	Facility		$8.51	$10.88	$12.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.93 / $21.03 / $26.65	Professional		$16.93	$21.03	$26.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.68 / $15.77 / $24.46	Professional		$11.68	$15.77	$24.46
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $9.19 / $17.23 / $201.88	Facility		$9.19	$17.23	$201.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $9.10 / $16.94 / $24.13	Professional		$9.10	$16.94	$24.13
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $22.54 / $22.54 / $22.54	Professional	25	$22.54	$22.54	$22.54
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $4.34 / $7.09 / $9.42	Professional	52	$4.34	$7.09	$9.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $17.18 / $20.25 / $28.68	Professional		$17.18	$20.25	$28.68