Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,773.62 / $2,773.62 / $4,326.85	Facility		$2,773.62	$2,773.62	$4,326.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,394.07 / $2,773.62 / $2,919.60	Professional		$2,394.07	$2,773.62	$2,919.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,282.54 / $3,261.78 / $5,800.30	Facility		$2,282.54	$3,261.78	$5,800.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,080.21 / $2,189.69 / $2,956.10	Professional		$2,080.21	$2,189.69	$2,956.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,189.69 / $3,036.38 / $7,007.04	Facility		$2,189.69	$3,036.38	$7,007.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,897.74 / $3,065.58 / $3,941.46	Professional		$1,897.74	$3,065.58	$3,941.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,400.00 / $2,919.60 / $4,588.32	Professional		$1,400.00	$2,919.60	$4,588.32
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,746.76 / $2,773.62 / $5,096.53	Facility		$2,746.76	$2,773.62	$5,096.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,746.76 / $2,773.62 / $3,503.52	Professional		$2,746.76	$2,773.62	$3,503.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,417.42 / $2,417.42 / $3,263.53	Professional		$2,417.42	$2,417.42	$3,263.53
United Facility/Professional Professional Modifier Low / Median / High Price $1,226.23 / $1,751.76 / $2,919.60	Professional		$1,226.23	$1,751.76	$2,919.60