Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $102.33	Professional		$58.88	$83.18	$102.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $489.78	Facility		$134.90	$134.90	$489.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $100.00 / $134.90	Professional		$10.23	$100.00	$134.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $75.86 / $102.33	Facility		$9.12	$75.86	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $102.33	Facility		$57.54	$57.54	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $154.88	Professional		$57.54	$57.54	$154.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $93.33 / $134.90	Professional		$10.72	$93.33	$134.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $120.23	Professional		$57.54	$57.54	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $44.67 / $97.72	Facility		$5.25	$44.67	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $95.50	Professional		$52.48	$66.07	$95.50