Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $549.54	Professional		$275.42	$354.81	$549.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,089.30 / $3,981.07	Facility		$891.25	$2,089.30	$3,981.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $691.83 / $741.31	Professional		$660.69	$691.83	$741.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $457.09 / $812.83	Professional		$331.13	$457.09	$812.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,318.26 / $1,479.11	Facility		$398.11	$1,318.26	$1,479.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $562.34 / $851.14	Professional		$346.74	$562.34	$851.14
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $457.09 / $478.63	Professional		$331.13	$457.09	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $562.34 / $831.76	Facility		$407.38	$562.34	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $331.13 / $489.78	Professional		$257.04	$331.13	$489.78