Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $251.19 / $457.09	Facility		$123.03	$251.19	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $316.23	Professional		$144.54	$218.78	$316.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $295.12 / $524.81	Facility		$194.98	$295.12	$524.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $194.98 / $194.98	Professional		$186.21	$194.98	$194.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $398.11 / $645.65	Facility		$263.03	$398.11	$645.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $338.84 / $354.81	Professional		$275.42	$338.84	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $575.44	Professional		$125.89	$162.18	$575.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $251.19 / $457.09	Facility		$125.89	$251.19	$457.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $354.81	Professional		$208.93	$263.03	$354.81
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $363.08	Professional		$117.49	$131.83	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $263.03 / $316.23	Facility		$234.42	$263.03	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $263.03	Professional		$109.65	$158.49	$263.03