Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,254.58 / $1,254.58 / $1,254.58	Facility		$1,254.58	$1,254.58	$1,254.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.91 / $1,254.58 / $1,254.58	Professional		$100.91	$1,254.58	$1,254.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,647.63 / $1,647.63 / $1,647.63	Facility		$1,647.63	$1,647.63	$1,647.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,565.25 / $1,647.63 / $2,224.30	Professional		$1,565.25	$1,647.63	$2,224.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,045.29 / $1,070.96 / $1,076.79	Facility		$1,045.29	$1,070.96	$1,076.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,318.10 / $1,318.10 / $1,318.10	Professional		$1,318.10	$1,318.10	$1,318.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $120.00	Facility		$120.00	$120.00	$120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.96 / $1,910.25	Professional		$120.00	$120.96	$1,910.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $83.02 / $83.02 / $1,254.58	Facility		$83.02	$83.02	$1,254.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $83.02 / $1,254.58 / $1,680.58	Professional		$83.02	$1,254.58	$1,680.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,400.49 / $1,400.49 / $1,400.49	Professional		$1,400.49	$1,400.49	$1,400.49
United Facility/Professional Professional Modifier Low / Median / High Price $57.60 / $76.64 / $154.55	Professional		$57.60	$76.64	$154.55