Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.14 / $21.88 / $21.88	Professional		$18.14	$21.88	$21.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.99 / $115.53 / $210.41	Facility		$57.99	$115.53	$210.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $38.31 / $51.72	Professional		$36.39	$38.31	$51.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.28 / $24.90 / $25.03	Facility		$24.28	$24.90	$25.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $30.65 / $30.65	Professional		$30.65	$30.65	$30.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.64 / $25.64 / $25.64	Facility		$25.64	$25.64	$25.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $25.64 / $44.25	Professional		$19.36	$25.64	$44.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $27.67 / $27.67	Facility		$21.88	$27.67	$27.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.67 / $40.22	Professional		$21.88	$27.67	$40.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.09 / $28.35 / $32.60	Professional		$24.09	$28.35	$32.60
United Facility/Professional Professional Modifier Low / Median / High Price $13.36 / $17.98 / $27.07	Professional		$13.36	$17.98	$27.07