Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $158.49	Professional		$87.10	$109.65	$158.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $691.83 / $1,318.26	Facility		$288.40	$691.83	$1,318.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $229.09 / $239.88	Professional		$218.78	$229.09	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $269.15	Professional		$81.28	$112.20	$269.15
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $436.52 / $489.78	Facility		$128.82	$436.52	$489.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $181.97 / $281.84	Professional		$107.15	$181.97	$281.84
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $114.82	Professional		$81.28	$112.20	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $181.97 / $245.47	Facility		$60.26	$181.97	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $151.36	Professional		$74.13	$107.15	$151.36