Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $1,908.26	Facility		$1,908.26	$1,908.26	$1,908.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $11,002.56	Professional		$1,908.26	$1,908.26	$11,002.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $598.46 / $6,159.70 / $15,895.41	Facility		$598.46	$6,159.70	$15,895.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.33 / $2,723.12 / $4,901.62	Professional		$265.33	$2,723.12	$4,901.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $487.89 / $487.89 / $4,878.89	Facility		$487.89	$487.89	$4,878.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $654.73 / $654.73 / $6,547.30	Professional		$654.73	$654.73	$6,547.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,300.60 / $4,300.60 / $4,300.60	Facility		$4,300.60	$4,300.60	$4,300.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,300.60 / $4,300.60 / $4,300.60	Professional		$4,300.60	$4,300.60	$4,300.60
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $1,908.26	Facility		$1,908.26	$1,908.26	$1,908.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,908.26 / $1,908.26 / $3,121.19	Professional		$1,908.26	$1,908.26	$3,121.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00