Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $114.82	Professional		$58.88	$79.43	$114.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $489.78 / $933.25	Facility		$204.17	$489.78	$933.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $162.18 / $169.82	Professional		$154.88	$162.18	$169.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $190.55	Professional		$77.62	$107.15	$190.55
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $309.03 / $346.74	Facility		$91.20	$309.03	$346.74
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $199.53	Professional		$79.43	$125.89	$199.53
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $112.20	Professional		$77.62	$107.15	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $128.82 / $181.97	Facility		$44.67	$128.82	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $107.15	Professional		$53.70	$75.86	$107.15