Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $3,311.31 / $3,715.35	Facility		$1,174.90	$3,311.31	$3,715.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,230.27 / $1,258.93	Professional		$1,174.90	$1,230.27	$1,258.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,230.27 / $1,230.27	Professional		$1,174.90	$1,230.27	$1,230.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,659.59	Professional		$1,258.93	$1,258.93	$1,659.59
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $3,311.31 / $3,715.35	Facility		$1,348.96	$3,311.31	$3,715.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,318.26 / $1,778.28	Professional		$1,174.90	$1,318.26	$1,778.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,348.96	Professional		$1,258.93	$1,258.93	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $1.26 / $512.86 / $1,202.26	Facility		$1.26	$512.86	$1,202.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,288.25 / $1,288.25	Professional		$1,202.26	$1,288.25	$1,288.25