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 $54.95 / $70.79 / $100.00	Professional		$54.95	$70.79	$100.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $426.58 / $812.83	Facility		$177.83	$426.58	$812.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $141.25 / $147.91	Professional		$134.90	$141.25	$147.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
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 $67.61 / $91.20 / $165.96	Professional		$67.61	$91.20	$165.96
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $269.15 / $302.00	Facility		$79.43	$269.15	$302.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $112.20 / $173.78	Professional		$69.18	$112.20	$173.78
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 $67.61 / $91.20 / $97.72	Professional		$67.61	$91.20	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $112.20 / $154.88	Facility		$38.90	$112.20	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $95.50	Professional		$46.77	$66.07	$95.50