Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $912.01 / $1,348.96	Professional		$741.31	$912.01	$1,348.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $4,897.79 / $9,332.54	Facility		$2,041.74	$4,897.79	$9,332.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,621.81 / $1,698.24	Professional		$1,513.56	$1,621.81	$1,698.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,000.00 / $1,905.46	Professional		$741.31	$1,000.00	$1,905.46
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $3,090.30 / $3,388.44	Facility		$912.01	$3,090.30	$3,388.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,288.25 / $1,949.84	Professional		$870.96	$1,288.25	$1,949.84
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,000.00 / $1,047.13	Professional		$741.31	$1,000.00	$1,047.13
United Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,288.25 / $2,187.76	Facility		$549.54	$1,288.25	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $776.25 / $1,148.15	Professional		$630.96	$776.25	$1,148.15