Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,122.02	Facility		$891.25	$1,122.02	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $794.33 / $1,096.48	Professional		$575.44	$794.33	$1,096.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,677.35 / $8,912.51	Facility		$1,995.26	$4,677.35	$8,912.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,548.82 / $1,621.81	Professional		$1,479.11	$1,548.82	$1,621.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility		$1,071.52	$1,071.52	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,023.29 / $1,819.70	Professional		$741.31	$1,023.29	$1,819.70
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,818.38 / $3,311.31	Facility		$891.25	$2,818.38	$3,311.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,230.27 / $1,905.46	Professional		$758.58	$1,230.27	$1,905.46
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,023.29 / $1,071.52	Professional		$741.31	$1,023.29	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $1,258.93 / $1,737.80	Facility		$426.58	$1,258.93	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $741.31 / $1,047.13	Professional		$524.81	$741.31	$1,047.13