Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $112.20	Professional		$54.95	$72.44	$112.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $316.23 / $602.56	Facility		$131.83	$316.23	$602.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $109.65	Professional		$104.71	$104.71	$109.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $141.25	Professional		$93.33	$128.82	$141.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $354.81 / $389.05	Facility		$72.44	$354.81	$389.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $173.78	Professional		$72.44	$128.82	$173.78
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $138.04	Professional		$93.33	$128.82	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $93.33 / $194.98	Facility		$61.66	$93.33	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $151.36	Professional		$64.57	$91.20	$151.36