Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Facility		$20.00	$20.00	$20.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.80	Professional		$20.00	$20.00	$20.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.52 / $228.18 / $411.93	Facility		$113.52	$228.18	$411.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.25 / $75.00 / $101.25	Professional		$71.25	$75.00	$101.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.23 / $16.23 / $28.11	Facility		$16.23	$16.23	$28.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.38 / $44.16 / $117.89	Professional		$27.38	$44.16	$117.89
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $3.71 / $3.71 / $20.00	Facility		$3.71	$3.71	$20.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $3.71 / $5.70 / $21.00	Professional		$3.71	$5.70	$21.00
United Facility/Professional Professional Modifier Low / Median / High Price $28.77 / $28.77 / $28.77	Professional		$28.77	$28.77	$28.77