Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,329.48 / $1,329.48 / $1,329.48	Facility		$1,329.48	$1,329.48	$1,329.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $861.06 / $1,329.48 / $1,329.48	Professional		$861.06	$1,329.48	$1,329.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,523.53 / $7,020.23 / $12,786.14	Facility		$3,523.53	$7,020.23	$12,786.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,211.57 / $2,327.96 / $3,142.76	Professional		$2,211.57	$2,327.96	$3,142.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,151.92 / $1,255.22 / $1,513.18	Facility		$1,151.92	$1,255.22	$1,513.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,862.38 / $1,862.38 / $1,862.38	Professional		$1,862.38	$1,862.38	$1,862.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,107.01 / $1,107.01 / $1,107.01	Facility		$1,107.01	$1,107.01	$1,107.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,107.01 / $1,107.01 / $2,698.88	Professional		$1,107.01	$1,107.01	$2,698.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,329.48 / $1,682.30 / $1,682.30	Facility		$1,329.48	$1,682.30	$1,682.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,329.48 / $1,682.30 / $2,618.37	Professional		$1,329.48	$1,682.30	$2,618.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $770.93	Professional		$30.00	$30.00	$770.93
United Facility/Professional Professional Modifier Low / Median / High Price $736.54 / $1,073.81 / $1,548.53	Professional		$736.54	$1,073.81	$1,548.53