Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $79.43 / $123.03	Professional		$61.66	$79.43	$123.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $416.87 / $812.83	Facility		$177.83	$416.87	$812.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $138.04 / $147.91	Professional		$131.83	$138.04	$147.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $162.18	Professional		$66.07	$91.20	$162.18
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $263.03 / $295.12	Facility		$79.43	$263.03	$295.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $169.82	Professional		$75.86	$112.20	$169.82
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $93.33	Professional		$66.07	$91.20	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $112.20 / $190.55	Facility		$46.77	$112.20	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $100.00	Professional		$54.95	$66.07	$100.00