Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.12 / $20.12 / $20.12	Facility		$20.12	$20.12	$20.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.71 / $20.12 / $20.12	Professional		$16.71	$20.12	$20.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.33 / $106.24 / $193.50	Facility		$53.33	$106.24	$193.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $35.22 / $47.56	Professional		$33.47	$35.22	$47.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.36 / $22.90 / $23.06	Facility		$22.36	$22.90	$23.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Professional		$28.18	$28.18	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.27 / $24.27 / $24.27	Facility		$24.27	$24.27	$24.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.27 / $24.27 / $40.88	Professional		$24.27	$24.27	$40.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $20.12 / $25.46 / $25.46	Facility		$20.12	$25.46	$25.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $20.12 / $25.46 / $36.99	Professional		$20.12	$25.46	$36.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.15 / $26.07 / $29.98	Professional		$22.15	$26.07	$29.98
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $16.54 / $25.22	Professional		$12.30	$16.54	$25.22