Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.05 / $14.05 / $14.05	Facility		$14.05	$14.05	$14.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $14.05 / $17.82	Professional		$14.05	$14.05	$17.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.11 / $135.69 / $247.16	Facility		$68.11	$135.69	$247.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $45.00 / $60.75	Professional		$42.75	$45.00	$60.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $130.81 / $130.81 / $130.81	Facility		$130.81	$130.81	$130.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10.75 / $10.75 / $10.75	Facility		$10.75	$10.75	$10.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.81 / $10.75 / $10.75	Professional		$8.81	$10.75	$10.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $14.05 / $32.97 / $32.97	Facility		$14.05	$32.97	$32.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $32.97 / $38.58	Professional		$14.05	$32.97	$38.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.48 / $8.81 / $13.21	Professional		$7.48	$8.81	$13.21
United Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $50.90 / $50.90	Professional		$50.90	$50.90	$50.90