Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $169.82	Professional		$83.18	$123.03	$169.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $758.58 / $1,479.11	Facility		$323.59	$758.58	$1,479.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $257.04 / $269.15	Professional		$239.88	$257.04	$269.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $295.12	Professional		$87.10	$120.23	$295.12
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $478.63 / $537.03	Facility		$144.54	$478.63	$537.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $204.17 / $309.03	Professional		$114.82	$204.17	$309.03
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $123.03	Professional		$87.10	$120.23	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $204.17 / $257.04	Facility		$64.57	$204.17	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $169.82	Professional		$79.43	$120.23	$169.82