Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,014.44 / $1,014.44 / $1,014.44	Facility		$1,014.44	$1,014.44	$1,014.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $751.55 / $1,014.44 / $1,014.44	Professional		$751.55	$1,014.44	$1,014.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,688.57 / $5,356.67 / $9,756.26	Facility		$2,688.57	$5,356.67	$9,756.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,687.50 / $1,776.32 / $2,398.03	Professional		$1,687.50	$1,776.32	$2,398.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,014.35 / $1,119.46 / $1,154.60	Facility		$1,014.35	$1,119.46	$1,154.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,421.06 / $1,421.06 / $1,421.06	Professional		$1,421.06	$1,421.06	$1,421.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.35 / $891.35 / $891.35	Facility		$891.35	$891.35	$891.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.35 / $891.35 / $2,059.13	Professional		$891.35	$891.35	$2,059.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,014.44 / $1,283.65 / $1,283.65	Facility		$1,014.44	$1,283.65	$1,283.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,002.14 / $1,283.65 / $1,865.13	Professional		$1,002.14	$1,283.65	$1,865.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,077.87 / $1,314.48 / $1,511.65	Professional		$1,077.87	$1,314.48	$1,511.65
United Facility/Professional Professional Modifier Low / Median / High Price $557.22 / $819.35 / $1,271.33	Professional		$557.22	$819.35	$1,271.33