Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,557.09 / $1,557.09 / $1,557.09	Facility		$1,557.09	$1,557.09	$1,557.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,557.09 / $1,557.09 / $21,537.01	Professional		$1,557.09	$1,557.09	$21,537.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $677.90 / $7,127.72 / $18,393.43	Facility		$677.90	$7,127.72	$18,393.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.18 / $3,991.36 / $5,671.93	Professional		$323.18	$3,991.36	$5,671.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $526.50 / $526.50 / $5,265.00	Facility		$526.50	$526.50	$5,265.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $708.89 / $708.89 / $7,088.89	Professional		$708.89	$708.89	$7,088.89
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,557.09 / $1,557.09 / $1,557.09	Facility		$1,557.09	$1,557.09	$1,557.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,557.09 / $1,557.09 / $3,796.57	Professional		$1,557.09	$1,557.09	$3,796.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00