Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,213.77 / $2,213.77 / $2,213.77	Facility		$2,213.77	$2,213.77	$2,213.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,918.60 / $2,213.77 / $2,213.77	Professional		$1,918.60	$2,213.77	$2,213.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,867.16 / $11,689.64 / $21,290.68	Facility		$5,867.16	$11,689.64	$21,290.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,682.57 / $3,876.39 / $5,233.13	Professional		$3,682.57	$3,876.39	$5,233.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,296.28 / $2,419.41 / $2,519.65	Facility		$2,296.28	$2,419.41	$2,519.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,101.11 / $3,101.11 / $3,101.11	Professional		$3,101.11	$3,101.11	$3,101.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,507.59 / $2,507.59 / $2,507.59	Facility		$2,507.59	$2,507.59	$2,507.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,507.59 / $2,507.59 / $4,494.00	Professional		$2,507.59	$2,507.59	$4,494.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,213.77 / $2,801.27 / $2,801.27	Facility		$2,213.77	$2,801.27	$2,801.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,213.77 / $2,801.27 / $4,359.96	Professional		$2,213.77	$2,801.27	$4,359.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $1,689.21	Professional		$30.00	$30.00	$1,689.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,379.98 / $1,820.37 / $2,774.41	Professional		$1,379.98	$1,820.37	$2,774.41