Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,253.75 / $1,253.75 / $1,253.75	Facility		$1,253.75	$1,253.75	$1,253.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,086.58 / $1,253.75 / $1,297.45	Professional		$1,086.58	$1,253.75	$1,297.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,322.81 / $6,620.33 / $12,057.80	Facility		$3,322.81	$6,620.33	$12,057.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,085.59 / $2,195.36 / $2,963.74	Professional		$2,085.59	$2,195.36	$2,963.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,301.36 / $1,393.76 / $1,426.98	Facility		$1,301.36	$1,393.76	$1,426.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,756.29 / $1,756.29 / $1,756.29	Professional		$1,756.29	$1,756.29	$1,756.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,304.10 / $1,304.10 / $1,304.10	Facility		$1,304.10	$1,304.10	$1,304.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,304.10 / $1,304.10 / $2,545.13	Professional		$1,304.10	$1,304.10	$2,545.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,253.75 / $1,586.49 / $1,586.49	Facility		$1,253.75	$1,586.49	$1,586.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,242.19 / $1,586.49 / $2,305.12	Professional		$1,242.19	$1,586.49	$2,305.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,332.14 / $1,624.57 / $1,868.25	Professional		$1,332.14	$1,624.57	$1,868.25
United Facility/Professional Professional Modifier Low / Median / High Price $782.07 / $1,030.96 / $1,571.29	Professional		$782.07	$1,030.96	$1,571.29