Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.76 / $10.76 / $10.76	Facility		$10.76	$10.76	$10.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.48 / $10.76 / $11.89	Professional		$9.48	$10.76	$11.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.53 / $57.35 / $103.53	Facility		$28.53	$57.35	$103.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.91 / $18.85 / $25.45	Professional		$17.91	$18.85	$25.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.93 / $12.25 / $13.94	Facility		$11.93	$12.25	$13.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.08 / $15.08 / $15.08	Professional		$15.08	$15.08	$15.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.18 / $12.18 / $12.18	Facility		$12.18	$12.18	$12.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.18 / $12.18 / $21.75	Professional		$12.18	$12.18	$21.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $10.76 / $13.61 / $13.61	Facility		$10.76	$13.61	$13.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $10.76 / $13.61 / $21.20	Professional		$10.76	$13.61	$21.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $7.18 / $9.15 / $14.53	Professional		$7.18	$9.15	$14.53