Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $140.00 / $140.00	Facility		$140.00	$140.00	$140.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $140.00 / $140.00	Professional		$140.00	$140.00	$140.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $404.65 / $806.22 / $1,468.39	Facility		$404.65	$806.22	$1,468.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.98 / $267.35 / $360.92	Professional		$253.98	$267.35	$360.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $177.31 / $177.31 / $238.05	Facility		$177.31	$177.31	$238.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $390.58 / $390.58 / $390.58	Professional		$390.58	$390.58	$390.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.29 / $223.29 / $223.29	Facility		$223.29	$223.29	$223.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.00 / $224.88 / $254.62	Professional		$163.00	$224.88	$254.62
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $1,060.17 / $1,060.17	Facility		$140.00	$1,060.17	$1,060.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $913.55 / $1,219.19	Professional		$140.00	$913.55	$1,219.19
United Facility/Professional Professional Modifier Low / Median / High Price $127.98 / $161.94 / $254.62	Professional		$127.98	$161.94	$254.62