Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $281.84	Professional		$131.83	$173.78	$281.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $758.58 / $1,445.44	Facility		$316.23	$758.58	$1,445.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $251.19 / $263.03	Professional		$239.88	$251.19	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $309.03 / $338.84	Professional		$229.09	$309.03	$338.84
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $831.76 / $912.01	Facility		$173.78	$831.76	$912.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $309.03 / $407.38	Professional		$173.78	$309.03	$407.38
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $309.03 / $323.59	Professional		$229.09	$309.03	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $223.87 / $524.81	Facility		$147.91	$223.87	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $354.81	Professional		$151.36	$213.80	$354.81