Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.67 / $16.67 / $16.67	Facility		$16.67	$16.67	$16.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.01 / $16.67 / $22.01	Professional		$15.01	$16.67	$22.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $166.49 / $331.72 / $604.16	Facility		$166.49	$331.72	$604.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.50 / $110.00 / $148.50	Professional		$104.50	$110.00	$148.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $87.70	Facility		$56.23	$56.23	$87.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.94 / $54.94 / $54.94	Facility		$54.94	$54.94	$54.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $54.94 / $73.45	Professional		$40.11	$54.94	$73.45
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $16.67 / $29.46 / $29.46	Facility		$16.67	$29.46	$29.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $16.67 / $29.46 / $50.00	Professional		$16.67	$29.46	$50.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $73.45 / $110.17	Professional		$62.43	$73.45	$110.17
United Facility/Professional Professional Modifier Low / Median / High Price $15.32 / $19.48 / $32.47	Professional		$15.32	$19.48	$32.47