Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.07 / $18.07 / $18.07	Facility		$18.07	$18.07	$18.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.07 / $18.07 / $18.07	Professional		$15.07	$18.07	$18.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.92 / $96.32 / $173.89	Facility		$47.92	$96.32	$173.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $31.66 / $42.74	Professional		$30.08	$31.66	$42.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.07 / $20.58 / $20.68	Facility		$20.07	$20.58	$20.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.33 / $25.33 / $25.33	Professional		$25.33	$25.33	$25.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.14 / $25.14 / $25.14	Facility		$25.14	$25.14	$25.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $25.14 / $36.75	Professional		$22.66	$25.14	$36.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $18.07 / $22.88 / $22.88	Facility		$18.07	$22.88	$22.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $18.07 / $22.88 / $35.61	Professional		$18.07	$22.88	$35.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $35.58 / $75.00	Professional		$35.58	$35.58	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $11.76 / $15.14 / $22.38	Professional		$11.76	$15.14	$22.38