Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $186.21	Professional		$93.33	$123.03	$186.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $758.58 / $1,445.44	Facility		$316.23	$758.58	$1,445.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $251.19 / $263.03	Professional		$234.42	$251.19	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $295.12	Professional		$120.23	$165.96	$295.12
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $478.63 / $524.81	Facility		$141.25	$478.63	$524.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $302.00	Professional		$120.23	$199.53	$302.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $177.83	Professional		$120.23	$165.96	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $199.53 / $288.40	Facility		$138.04	$199.53	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $165.96	Professional		$87.10	$120.23	$165.96