Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $251.19	Professional		$128.82	$158.49	$251.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $912.01 / $1,737.80	Facility		$389.05	$912.01	$1,737.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $302.00 / $323.59	Professional		$288.40	$302.00	$323.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
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 $144.54 / $169.82 / $354.81	Professional		$144.54	$169.82	$354.81
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $575.44 / $645.65	Facility		$173.78	$575.44	$645.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $245.47 / $371.54	Professional		$158.49	$245.47	$371.54
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 $144.54 / $169.82 / $173.78	Professional		$144.54	$169.82	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $245.47 / $371.54	Facility		$177.83	$245.47	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $213.80	Professional		$112.20	$144.54	$213.80