Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $186.21	Professional		$95.50	$120.23	$186.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $724.44 / $1,380.38	Facility		$309.03	$724.44	$1,380.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $239.88 / $251.19	Professional		$229.09	$239.88	$251.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $281.84	Professional		$123.03	$169.82	$281.84
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $457.09 / $512.86	Facility		$138.04	$457.09	$512.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $295.12	Professional		$114.82	$186.21	$295.12
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $181.97	Professional		$123.03	$169.82	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $194.98 / $275.42	Facility		$134.90	$194.98	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $162.18	Professional		$85.11	$114.82	$162.18