Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $162.18 / $257.04	Facility		$83.18	$162.18	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $81.28 / $128.82	Professional		$79.43	$81.28	$128.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $173.78 / $346.74	Facility		$91.20	$173.78	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $81.28 / $85.11	Professional		$77.62	$81.28	$85.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $93.33 / $117.49	Facility		$77.62	$93.33	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $181.97	Professional		$77.62	$77.62	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $91.20	Professional		$79.43	$79.43	$91.20
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $199.53 / $257.04	Facility		$79.43	$199.53	$257.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $81.28 / $112.20	Professional		$79.43	$81.28	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $87.10	Professional		$79.43	$79.43	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $79.43	Facility		$77.62	$77.62	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $100.00	Professional		$77.62	$85.11	$100.00