Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,235.20 / $1,235.20 / $1,235.20	Facility		$1,235.20	$1,235.20	$1,235.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.15 / $1,235.20 / $1,235.20	Professional		$1,047.15	$1,235.20	$1,235.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,273.67 / $6,522.41 / $11,879.46	Facility		$3,273.67	$6,522.41	$11,879.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,054.75 / $2,162.89 / $2,919.90	Professional		$2,054.75	$2,162.89	$2,919.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,258.70 / $1,385.92 / $1,405.88	Facility		$1,258.70	$1,385.92	$1,405.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,730.31 / $1,730.31 / $1,730.31	Professional		$1,730.31	$1,730.31	$1,730.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,399.15 / $1,399.15 / $1,399.15	Facility		$1,399.15	$1,399.15	$1,399.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,399.15 / $1,399.15 / $2,507.63	Professional		$1,399.15	$1,399.15	$2,507.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,235.20 / $1,563.00 / $1,563.00	Facility		$1,235.20	$1,563.00	$1,563.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,235.20 / $1,563.00 / $2,432.69	Professional		$1,235.20	$1,563.00	$2,432.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $845.61	Professional		$30.00	$30.00	$845.61
United Facility/Professional Professional Modifier Low / Median / High Price $805.07 / $1,015.70 / $1,548.03	Professional		$805.07	$1,015.70	$1,548.03