Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,231.33 / $4,833.27 / $5,954.36	Facility		$1,231.33	$4,833.27	$5,954.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,018.40 / $1,231.33 / $1,231.33	Professional		$1,018.40	$1,231.33	$1,231.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,617.09 / $1,617.09 / $1,617.09	Professional		$1,617.09	$1,617.09	$1,617.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,263.43 / $6,502.00 / $11,842.27	Facility		$3,263.43	$6,502.00	$11,842.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,048.31 / $2,156.12 / $2,910.76	Professional		$2,048.31	$2,156.12	$2,910.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,147.34 / $1,272.61 / $1,401.48	Facility		$1,147.34	$1,272.61	$1,401.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,724.90 / $1,724.90 / $1,724.90	Professional		$1,724.90	$1,724.90	$1,724.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,184.20 / $1,184.20 / $1,184.20	Facility		$1,184.20	$1,184.20	$1,184.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $999.31 / $1,184.20 / $2,499.75	Professional		$999.31	$1,184.20	$2,499.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,558.12 / $4,833.27 / $5,954.36	Facility		$1,558.12	$4,833.27	$5,954.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,158.07 / $1,558.12 / $2,263.92	Professional		$1,158.07	$1,558.12	$2,263.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,308.33 / $1,595.53 / $1,834.85	Professional		$1,308.33	$1,595.53	$1,834.85
United Facility/Professional Professional Modifier Low / Median / High Price $689.52 / $977.66 / $1,440.66	Professional		$689.52	$977.66	$1,440.66