Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $831.76 / $1,202.26	Professional		$676.08	$831.76	$1,202.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,786.30 / $9,120.11	Facility		$1,995.26	$4,786.30	$9,120.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,584.89 / $1,659.59	Professional		$1,513.56	$1,584.89	$1,659.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,122.02 / $1,862.09	Professional		$812.83	$1,122.02	$1,862.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $3,019.95 / $3,388.44	Facility		$912.01	$3,019.95	$3,388.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,258.93 / $1,949.84	Professional		$794.33	$1,258.93	$1,949.84
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,122.02 / $1,202.26	Professional		$812.83	$1,122.02	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,258.93 / $1,949.84	Facility		$478.63	$1,258.93	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $741.31 / $1,148.15	Professional		$549.54	$741.31	$1,148.15