Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,022.80 / $1,022.80 / $1,022.80	Facility		$1,022.80	$1,022.80	$1,022.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $886.43 / $961.94 / $1,022.80	Professional		$886.43	$961.94	$1,022.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,350.47 / $1,350.47 / $1,350.47	Professional		$1,350.47	$1,350.47	$1,350.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,619.58 / $5,400.85 / $10,265.29	Facility		$2,619.58	$5,400.85	$10,265.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,701.42 / $1,790.97 / $2,417.81	Professional		$1,701.42	$1,790.97	$2,417.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,136.21 / $1,164.13 / $1,170.41	Facility		$1,136.21	$1,164.13	$1,170.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,432.78 / $1,432.78 / $1,432.78	Professional		$1,432.78	$1,432.78	$1,432.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,162.20 / $1,162.20 / $1,433.06	Facility		$1,162.20	$1,162.20	$1,433.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,162.20 / $1,162.20 / $2,076.38	Professional		$1,162.20	$1,162.20	$2,076.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,022.80 / $1,294.23 / $1,294.23	Facility		$1,022.80	$1,294.23	$1,294.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $960.89 / $1,294.23 / $1,806.49	Professional		$960.89	$1,294.23	$1,806.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,086.76 / $1,325.32 / $1,524.11	Professional		$1,086.76	$1,325.32	$1,524.11
United Facility/Professional Professional Modifier Low / Median / High Price $624.96 / $841.04 / $1,281.83	Professional		$624.96	$841.04	$1,281.83