Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $741.31 / $1,071.52	Professional		$602.56	$741.31	$1,071.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $4,265.80 / $8,128.31	Facility		$1,778.28	$4,265.80	$8,128.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,412.54 / $1,479.11	Professional		$1,348.96	$1,412.54	$1,479.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $912.01 / $1,659.59	Professional		$660.69	$912.01	$1,659.59
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,691.53 / $3,019.95	Facility		$794.33	$2,691.53	$3,019.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,122.02 / $1,737.80	Professional		$724.44	$1,122.02	$1,737.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $912.01 / $977.24	Professional		$660.69	$912.01	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $1,122.02 / $1,698.24	Facility		$426.58	$1,122.02	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $1,000.00	Professional		$489.78	$660.69	$1,000.00