Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.39 / $20.39 / $20.39	Facility		$20.39	$20.39	$20.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.52 / $20.39 / $20.39	Professional		$18.52	$20.39	$20.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.03 / $107.66 / $196.08	Facility		$54.03	$107.66	$196.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $35.70 / $48.20	Professional		$33.92	$35.70	$48.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.21 / $23.30 / $30.94	Facility		$23.21	$23.30	$30.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $28.56 / $28.56	Professional		$28.56	$28.56	$28.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.10 / $23.10 / $23.10	Facility		$23.10	$23.10	$23.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $23.10 / $41.25	Professional		$23.10	$23.10	$41.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $20.39 / $25.80 / $25.80	Facility		$20.39	$25.80	$25.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $25.80 / $41.05	Professional		$20.39	$25.80	$41.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.66 / $26.42 / $30.38	Professional		$21.66	$26.42	$30.38
United Facility/Professional Professional Modifier Low / Median / High Price $13.95 / $17.07 / $25.55	Professional		$13.95	$17.07	$25.55