Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $794.33 / $1,148.15	Professional		$616.60	$794.33	$1,148.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $4,786.30 / $9,332.54	Facility		$2,041.74	$4,786.30	$9,332.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,584.89 / $1,698.24	Professional		$1,513.56	$1,584.89	$1,698.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,047.13 / $1,862.09	Professional		$758.58	$1,047.13	$1,862.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $3,019.95 / $3,388.44	Facility		$912.01	$3,019.95	$3,388.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,258.93 / $1,949.84	Professional		$758.58	$1,258.93	$1,949.84
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,047.13 / $1,071.52	Professional		$758.58	$1,047.13	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,288.25 / $1,862.09	Facility		$912.01	$1,288.25	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,096.48	Professional		$575.44	$758.58	$1,096.48