Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Facility		$4,265.80	$4,265.80	$4,265.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,467.37 / $4,265.80	Professional		$2,344.23	$3,467.37	$4,265.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,128.61 / $5,128.61 / $19,054.61	Facility		$5,128.61	$5,128.61	$19,054.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $3,890.45 / $5,128.61	Professional		$398.11	$3,890.45	$5,128.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $4,365.16	Facility		$323.59	$323.59	$4,365.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,630.78 / $3,630.78	Facility		$2,630.27	$3,630.78	$3,630.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $3,630.78 / $5,754.40	Professional		$389.05	$3,630.78	$5,754.40
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,801.89 / $7,585.78	Professional		$2,511.89	$3,801.89	$7,585.78
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility		$3,630.78	$3,630.78	$3,630.78
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $3,630.78 / $3,630.78	Professional		$389.05	$3,630.78	$3,630.78
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $501.19 / $2,951.21	Facility		$223.87	$501.19	$2,951.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,344.23 / $3,388.44	Professional		$1,513.56	$2,344.23	$3,388.44