Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $295.12	Facility		$162.18	$162.18	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $213.80	Professional		$100.00	$138.04	$213.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $190.55 / $338.84	Facility		$128.82	$190.55	$338.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $128.82 / $128.82	Professional		$120.23	$128.82	$128.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $229.09	Professional		$169.82	$218.78	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $77.62 / $371.54	Professional		$58.88	$77.62	$371.54
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $295.12	Facility		$162.18	$162.18	$295.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $204.17	Professional		$120.23	$158.49	$204.17
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $72.44 / $234.42	Professional		$58.88	$72.44	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $169.82 / $169.82	Facility		$151.36	$169.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $128.82	Professional		$53.70	$77.62	$128.82