Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $251.19 / $251.19	Facility		$169.82	$251.19	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $239.88	Professional		$120.23	$154.88	$239.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $891.25 / $1,698.24	Facility		$380.19	$891.25	$1,698.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $295.12 / $309.03	Professional		$281.84	$295.12	$309.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $346.74	Professional		$138.04	$190.55	$346.74
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $537.03 / $630.96	Facility		$169.82	$537.03	$630.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $234.42 / $363.08	Professional		$147.91	$234.42	$363.08
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $204.17	Professional		$138.04	$190.55	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $239.88 / $354.81	Facility		$89.13	$239.88	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $208.93	Professional		$102.33	$138.04	$208.93