Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,148.15 / $1,737.80	Professional		$891.25	$1,148.15	$1,737.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $6,606.93 / $12,589.25	Facility		$2,754.23	$6,606.93	$12,589.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,187.76 / $2,290.87	Professional		$2,089.30	$2,187.76	$2,290.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,318.26 / $2,570.40	Professional		$954.99	$1,318.26	$2,570.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $4,168.69 / $4,677.35	Facility		$1,258.93	$4,168.69	$4,677.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,737.80 / $2,691.53	Professional		$1,096.48	$1,737.80	$2,691.53
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,318.26 / $1,348.96	Professional		$954.99	$1,318.26	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,737.80 / $2,754.23	Facility		$676.08	$1,737.80	$2,754.23
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,023.29 / $1,584.89	Professional		$776.25	$1,023.29	$1,584.89