Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $141.25	Professional		$77.62	$114.82	$141.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $645.65	Facility		$131.83	$131.83	$645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $173.78 / $173.78	Professional		$13.49	$173.78	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $109.65 / $147.91	Facility		$11.48	$109.65	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $151.36	Facility		$114.82	$114.82	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $204.17	Professional		$114.82	$114.82	$204.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $141.25 / $229.09	Professional		$19.05	$141.25	$229.09
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $151.36	Facility		$114.82	$114.82	$151.36
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $151.36	Professional		$114.82	$114.82	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $75.86 / $125.89	Facility		$9.12	$75.86	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $117.49 / $158.49	Professional		$72.44	$117.49	$158.49