Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.79 / $10.79 / $10.79	Facility		$10.79	$10.79	$10.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.23 / $10.79 / $10.79	Professional		$9.23	$10.79	$10.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.89 / $18.89 / $18.89	Professional		$18.89	$18.89	$18.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.59 / $57.47 / $103.75	Facility		$28.59	$57.47	$103.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.95 / $18.89 / $25.50	Professional		$17.95	$18.89	$25.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.28 / $13.55 / $14.79	Facility		$12.28	$13.55	$14.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.11 / $15.11 / $15.11	Professional		$15.11	$15.11	$15.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.44 / $14.44 / $14.44	Facility		$14.44	$14.44	$14.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $14.44 / $21.75	Professional		$14.44	$14.44	$21.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $10.79 / $13.65 / $13.65	Facility		$10.79	$13.65	$13.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $10.69 / $13.65 / $21.72	Professional		$10.69	$13.65	$21.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.46 / $13.98 / $16.07	Professional		$11.46	$13.98	$16.07
United Facility/Professional Professional Modifier Low / Median / High Price $7.86 / $9.43 / $14.52	Professional		$7.86	$9.43	$14.52