Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $169.82	Professional		$83.18	$104.71	$169.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $575.44 / $1,096.48	Facility		$245.47	$575.44	$1,096.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $190.55 / $199.53	Professional		$181.97	$190.55	$199.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $223.87	Professional		$91.20	$123.03	$223.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $363.08 / $407.38	Facility		$109.65	$363.08	$407.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $234.42	Professional		$100.00	$154.88	$234.42
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $128.82	Professional		$91.20	$123.03	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $154.88 / $263.03	Facility		$64.57	$154.88	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $138.04	Professional		$75.86	$91.20	$138.04