Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $147.91	Professional		$77.62	$109.65	$147.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $707.95 / $1,348.96	Facility		$295.12	$707.95	$1,348.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $245.47	Professional		$223.87	$234.42	$245.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $275.42	Professional		$83.18	$112.20	$275.42
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $446.68 / $501.19	Facility		$131.83	$446.68	$501.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $186.21 / $288.40	Professional		$100.00	$186.21	$288.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $120.23	Professional		$83.18	$112.20	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $186.21 / $239.88	Facility		$104.71	$186.21	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $154.88	Professional		$72.44	$109.65	$154.88