Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $85.11	Professional		$41.69	$54.95	$85.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $338.84 / $645.65	Facility		$141.25	$338.84	$645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $112.20 / $117.49	Professional		$107.15	$112.20	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.26 / $131.83	Professional		$43.65	$60.26	$131.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $213.80 / $239.88	Facility		$64.57	$213.80	$239.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $89.13 / $138.04	Professional		$52.48	$89.13	$138.04
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.26 / $64.57	Professional		$43.65	$60.26	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $89.13 / $131.83	Facility		$63.10	$89.13	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $75.86	Professional		$39.81	$53.70	$75.86