Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $64.57	Professional		$30.90	$44.67	$64.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $281.84 / $549.54	Facility		$120.23	$281.84	$549.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $100.00	Professional		$89.13	$93.33	$100.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $109.65	Professional		$38.90	$52.48	$109.65
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $177.83 / $199.53	Facility		$52.48	$177.83	$199.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $75.86 / $114.82	Professional		$42.66	$75.86	$114.82
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $56.23	Professional		$38.90	$52.48	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $75.86 / $97.72	Facility		$23.99	$75.86	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $63.10	Professional		$29.51	$43.65	$63.10