Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11.81 / $11.81 / $11.81	Facility		$11.81	$11.81	$11.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.25 / $11.81 / $11.81	Professional		$10.25	$11.81	$11.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.30 / $62.36 / $113.58	Facility		$31.30	$62.36	$113.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.64 / $20.68 / $27.92	Professional		$19.64	$20.68	$27.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.12 / $13.44 / $13.53	Facility		$13.12	$13.44	$13.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.54 / $16.54 / $16.54	Professional		$16.54	$16.54	$16.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.40 / $13.40 / $13.40	Facility		$13.40	$13.40	$13.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.40 / $13.40 / $24.00	Professional		$13.40	$13.40	$24.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $11.81 / $14.96 / $14.96	Facility		$11.81	$14.96	$14.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $11.81 / $14.96 / $21.71	Professional		$11.81	$14.96	$21.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.54 / $15.30 / $17.59	Professional		$12.54	$15.30	$17.59
United Facility/Professional Facility Modifier Low / Median / High Price $9.11 / $9.11 / $11.68	Facility		$9.11	$9.11	$11.68
United Facility/Professional Professional Modifier Low / Median / High Price $7.20 / $9.73 / $14.83	Professional		$7.20	$9.73	$14.83