Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $331.13 / $416.87	Professional		$263.03	$331.13	$416.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,445.44 / $2,691.53	Facility		$645.65	$1,445.44	$2,691.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $562.34 / $562.34	Professional		$524.81	$562.34	$562.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $457.09	Facility		$33.88	$33.88	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $338.84 / $616.60	Professional		$40.74	$338.84	$616.60
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $933.25 / $1,047.13	Facility		$380.19	$933.25	$1,047.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $389.05 / $660.69	Professional		$54.95	$389.05	$660.69
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $338.84 / $346.74	Professional		$40.74	$338.84	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $162.18 / $275.42	Facility		$21.88	$162.18	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $331.13	Professional		$165.96	$213.80	$331.13