Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.82 / $14.82 / $14.82	Facility		$14.82	$14.82	$14.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.34 / $14.82 / $19.55	Professional		$13.34	$14.82	$19.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.95 / $211.09 / $384.47	Facility		$105.95	$211.09	$384.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.50 / $70.00 / $94.50	Professional		$66.50	$70.00	$94.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.61 / $23.61 / $25.23	Facility		$23.61	$23.61	$25.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.60 / $27.60 / $27.60	Facility		$27.60	$27.60	$27.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $27.60 / $32.40	Professional		$24.48	$27.60	$32.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $14.82 / $26.19 / $26.19	Facility		$14.82	$26.19	$26.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $14.82 / $26.19 / $30.64	Professional		$14.82	$26.19	$30.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.80 / $24.48 / $36.72	Professional		$20.80	$24.48	$36.72
United Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $17.30 / $28.87	Professional		$12.00	$17.30	$28.87