Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,077.92 / $1,077.92 / $1,077.92	Facility		$1,077.92	$1,077.92	$1,077.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $988.09 / $1,077.92 / $1,077.92	Professional		$988.09	$1,077.92	$1,077.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,856.82 / $5,691.88 / $10,366.79	Facility		$2,856.82	$5,691.88	$10,366.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,793.11 / $1,887.48 / $2,548.10	Professional		$1,793.11	$1,887.48	$2,548.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,226.85 / $1,301.56 / $1,477.46	Facility		$1,226.85	$1,301.56	$1,477.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,509.98 / $1,509.98 / $1,509.98	Professional		$1,509.98	$1,509.98	$1,509.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,179.41 / $1,179.41 / $1,179.41	Facility		$1,179.41	$1,179.41	$1,179.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,179.40 / $1,179.41 / $2,188.13	Professional		$1,179.40	$1,179.41	$2,188.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,077.92 / $1,363.98 / $1,363.98	Facility		$1,077.92	$1,363.98	$1,363.98
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,069.81 / $1,363.98 / $2,122.92	Professional		$1,069.81	$1,363.98	$2,122.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,145.32 / $1,396.74 / $1,606.25	Professional		$1,145.32	$1,396.74	$1,606.25
United Facility/Professional Professional Modifier Low / Median / High Price $737.30 / $902.33 / $1,350.91	Professional		$737.30	$902.33	$1,350.91