Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.19 / $16.19 / $16.19	Facility		$16.19	$16.19	$16.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $16.19 / $16.19	Professional		$14.04	$16.19	$16.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.89 / $85.46 / $155.65	Facility		$42.89	$85.46	$155.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $28.34 / $38.26	Professional		$26.92	$28.34	$38.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.98 / $18.42 / $18.54	Facility		$17.98	$18.42	$18.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.67 / $22.67 / $22.67	Professional		$22.67	$22.67	$22.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.80 / $15.80 / $15.80	Facility		$15.80	$15.80	$15.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.80 / $15.80 / $33.00	Professional		$15.80	$15.80	$33.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $16.19 / $20.48 / $20.48	Facility		$16.19	$20.48	$20.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $16.19 / $20.48 / $29.75	Professional		$16.19	$20.48	$29.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.19 / $20.97 / $24.11	Professional		$17.19	$20.97	$24.11
United Facility/Professional Professional Modifier Low / Median / High Price $10.51 / $13.55 / $19.30	Professional		$10.51	$13.55	$19.30