Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6.85 / $6.85 / $6.85	Facility		$6.85	$6.85	$6.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $6.85 / $9.05	Professional		$6.17	$6.85	$9.05
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 $16.67 / $16.67 / $16.67	Facility		$16.67	$16.67	$16.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.37 / $28.37 / $28.37	Facility		$28.37	$28.37	$28.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.34 / $28.37 / $28.37	Professional		$17.34	$28.37	$28.37
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $6.85 / $12.11 / $12.11	Facility		$6.85	$12.11	$12.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $6.85 / $12.11 / $14.68	Professional		$6.85	$12.11	$14.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Facility Modifier Low / Median / High Price $7.75 / $8.00 / $35.70	Facility		$7.75	$8.00	$35.70
United Facility/Professional Professional Modifier Low / Median / High Price $5.81 / $8.01 / $13.70	Professional		$5.81	$8.01	$13.70