Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $524.81	Professional		$263.03	$338.84	$524.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $2,089.30 / $3,981.07	Facility		$870.96	$2,089.30	$3,981.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $691.83 / $724.44	Professional		$645.65	$691.83	$724.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $812.83	Professional		$354.81	$478.63	$812.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $1,318.26 / $1,445.44	Facility		$389.05	$1,318.26	$1,445.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $549.54 / $831.76	Professional		$323.59	$549.54	$831.76
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $512.86	Professional		$354.81	$478.63	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $549.54 / $794.33	Facility		$389.05	$549.54	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $457.09	Professional		$245.47	$323.59	$457.09