Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $389.05	Professional		$213.80	$309.03	$389.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $1,698.24	Facility		$457.09	$457.09	$1,698.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $457.09 / $457.09	Professional		$35.48	$457.09	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $302.00 / $426.58	Facility		$30.20	$302.00	$426.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $426.58	Facility		$302.00	$302.00	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $309.03 / $524.81	Professional		$302.00	$309.03	$524.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $389.05 / $676.08	Professional		$47.86	$389.05	$676.08
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $398.11	Facility		$302.00	$302.00	$398.11
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $309.03 / $426.58	Professional		$302.00	$309.03	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $199.53 / $363.08	Facility		$25.12	$199.53	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $457.09	Professional		$194.98	$346.74	$457.09