Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $660.69 / $1,000.00	Professional		$524.81	$660.69	$1,000.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,890.45 / $7,585.78	Facility		$1,659.59	$3,890.45	$7,585.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,318.26 / $1,380.38	Professional		$1,230.27	$1,318.26	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $1,513.56	Professional		$524.81	$707.95	$1,513.56
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $2,454.71 / $2,754.23	Facility		$741.31	$2,454.71	$2,754.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,047.13 / $1,584.89	Professional		$645.65	$1,047.13	$1,584.89
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $758.58	Professional		$524.81	$707.95	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $1,047.13 / $1,548.82	Facility		$389.05	$1,047.13	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $912.01	Professional		$446.68	$616.60	$912.01