Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,839.19 / $1,839.19 / $1,839.19	Facility		$1,839.19	$1,839.19	$1,839.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,591.04 / $1,839.19 / $1,851.83	Professional		$1,591.04	$1,839.19	$1,851.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,874.43 / $9,711.74 / $17,688.27	Facility		$4,874.43	$9,711.74	$17,688.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,656.91 / $3,220.50 / $4,347.68	Professional		$2,656.91	$3,220.50	$4,347.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,912.68 / $1,965.93 / $2,093.33	Facility		$1,912.68	$1,965.93	$2,093.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,576.40 / $2,576.40 / $2,576.40	Professional		$2,576.40	$2,576.40	$2,576.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,815.81 / $1,815.81 / $1,815.81	Facility		$1,815.81	$1,815.81	$1,815.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,815.81 / $1,815.81 / $3,733.50	Professional		$1,815.81	$1,815.81	$3,733.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,839.19 / $2,327.25 / $2,327.25	Facility		$1,839.19	$2,327.25	$2,327.25
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,839.19 / $2,327.25 / $3,622.24	Professional		$1,839.19	$2,327.25	$3,622.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $1,389.50	Professional		$30.00	$30.00	$1,389.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,208.11 / $1,512.34 / $2,358.54	Professional		$1,208.11	$1,512.34	$2,358.54