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 $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $812.83 / $1,548.82	Facility		$338.84	$812.83	$1,548.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $269.15 / $281.84	Professional		$251.19	$269.15	$281.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $223.87	Professional		$162.18	$162.18	$223.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $2,818.38 / $3,090.30	Facility		$141.25	$2,818.38	$3,090.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $1,071.52 / $1,513.56	Professional		$141.25	$1,071.52	$1,513.56
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $223.87	Professional		$162.18	$223.87	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $2.82 / $169.82 / $229.09	Facility		$2.82	$169.82	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $257.04	Professional		$128.82	$151.36	$257.04