Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.57 / $19.57 / $19.57	Facility		$19.57	$19.57	$19.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $19.57 / $24.91	Professional		$19.57	$19.57	$24.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.41 / $90.47 / $164.77	Facility		$45.41	$90.47	$164.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $30.00 / $40.50	Professional		$28.50	$30.00	$40.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.38 / $37.38 / $37.38	Facility		$37.38	$37.38	$37.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.72 / $23.72 / $23.72	Facility		$23.72	$23.72	$23.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.47 / $23.72 / $23.72	Professional		$8.47	$23.72	$23.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $19.57 / $32.97 / $32.97	Facility		$19.57	$32.97	$32.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $31.87 / $37.92	Professional		$19.57	$31.87	$37.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.19 / $8.47 / $12.70	Professional		$7.19	$8.47	$12.70
United Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $50.90 / $50.90	Professional		$50.90	$50.90	$50.90