Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.47 / $15.47 / $15.47	Facility		$15.47	$15.47	$15.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.90 / $15.47 / $15.84	Professional		$12.90	$15.47	$15.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.02 / $82.45 / $148.84	Facility		$41.02	$82.45	$148.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $27.10 / $36.59	Professional		$25.75	$27.10	$36.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.41 / $17.62 / $19.29	Facility		$16.41	$17.62	$19.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.68 / $21.68 / $21.68	Professional		$21.68	$21.68	$21.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $16.89 / $16.89	Facility		$16.89	$16.89	$16.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $16.89 / $31.50	Professional		$16.89	$16.89	$31.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $15.47 / $19.57 / $19.57	Facility		$15.47	$19.57	$19.57
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $15.33 / $19.57 / $28.45	Professional		$15.33	$19.57	$28.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.44 / $20.05 / $23.05	Professional		$16.44	$20.05	$23.05
United Facility/Professional Professional Modifier Low / Median / High Price $10.49 / $12.95 / $19.39	Professional		$10.49	$12.95	$19.39