Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $128.82	Professional		$72.44	$91.20	$128.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $524.81 / $1,000.00	Facility		$218.78	$524.81	$1,000.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $181.97	Professional		$165.96	$173.78	$181.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $204.17	Professional		$75.86	$104.71	$204.17
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $331.13 / $363.08	Facility		$97.72	$331.13	$363.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $138.04 / $213.80	Professional		$87.10	$138.04	$213.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $112.20	Professional		$75.86	$104.71	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $138.04 / $208.93	Facility		$52.48	$138.04	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $123.03	Professional		$60.26	$81.28	$123.03