Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,202.31 / $2,202.31 / $2,202.31	Facility		$2,202.31	$2,202.31	$2,202.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,829.37 / $2,202.31 / $2,202.31	Professional		$1,829.37	$2,202.31	$2,202.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,836.79 / $11,629.15 / $21,180.51	Facility		$5,836.79	$11,629.15	$21,180.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,663.51 / $3,856.33 / $5,206.05	Professional		$3,663.51	$3,856.33	$5,206.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,446.55 / $2,506.61 / $2,520.21	Facility		$2,446.55	$2,506.61	$2,520.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,085.06 / $3,085.06 / $3,085.06	Professional		$3,085.06	$3,085.06	$3,085.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,326.75 / $2,326.75 / $2,326.75	Facility		$2,326.75	$2,326.75	$2,326.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,326.75 / $2,326.75 / $4,470.75	Professional		$2,326.75	$2,326.75	$4,470.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,202.31 / $2,786.76 / $2,786.76	Facility		$2,202.31	$2,786.76	$2,786.76
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,069.05 / $2,786.76 / $4,049.14	Professional		$2,069.05	$2,786.76	$4,049.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,425.62 / $2,853.68 / $3,281.73	Professional		$2,425.62	$2,853.68	$3,281.73
United Facility/Professional Professional Modifier Low / Median / High Price $1,345.70 / $1,810.94 / $2,725.78	Professional		$1,345.70	$1,810.94	$2,725.78