Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.00 / $173.00 / $173.00	Facility		$173.00	$173.00	$173.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $173.00 / $173.00	Professional		$173.00	$173.00	$173.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $378.39 / $760.60 / $1,373.10	Facility		$378.39	$760.60	$1,373.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.50 / $250.00 / $337.50	Professional		$237.50	$250.00	$337.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $144.49 / $144.49 / $144.49	Facility		$144.49	$144.49	$144.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.02 / $263.02 / $263.02	Facility		$263.02	$263.02	$263.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.85 / $263.02 / $263.02	Professional		$147.85	$263.02	$263.02
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $61.51 / $61.51 / $173.00	Facility		$61.51	$61.51	$173.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.51 / $79.41 / $173.00	Professional		$61.51	$79.41	$173.00
United Facility/Professional Professional Modifier Low / Median / High Price $614.21 / $614.21 / $614.21	Professional		$614.21	$614.21	$614.21