Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $1,663.50	Facility		$1,663.50	$1,663.50	$1,663.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $3,424.84	Professional		$1,663.50	$1,663.50	$3,424.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $993.76 / $12,688.04 / $16,917.37	Facility		$993.76	$12,688.04	$16,917.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.43 / $2,509.92 / $4,755.63	Professional		$257.43	$2,509.92	$4,755.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $333.45 / $349.54 / $3,495.36	Facility		$333.45	$349.54	$3,495.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,915.00 / $3,915.00 / $4,893.75	Professional		$3,915.00	$3,915.00	$4,893.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $3,679.25	Professional		$1,663.50	$1,663.50	$3,679.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,043.76 / $1,565.64 / $3,540.72	Professional		$1,043.76	$1,565.64	$3,540.72