Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,052.13 / $1,052.13 / $1,052.13	Facility		$1,052.13	$1,052.13	$1,052.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $873.95 / $1,052.13 / $1,052.13	Professional		$873.95	$1,052.13	$1,052.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,788.47 / $5,555.70 / $10,118.76	Facility		$2,788.47	$5,555.70	$10,118.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,750.20 / $1,842.32 / $2,487.13	Professional		$1,750.20	$1,842.32	$2,487.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,168.78 / $1,197.51 / $1,203.98	Facility		$1,168.78	$1,197.51	$1,203.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,473.86 / $1,473.86 / $1,473.86	Professional		$1,473.86	$1,473.86	$1,473.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,028.38 / $1,028.38 / $1,028.38	Facility		$1,028.38	$1,028.38	$1,028.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,028.38 / $1,028.38 / $2,135.63	Professional		$1,028.38	$1,028.38	$2,135.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,052.13 / $1,331.35 / $1,331.35	Facility		$1,052.13	$1,331.35	$1,331.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,052.13 / $1,331.35 / $2,072.14	Professional		$1,052.13	$1,331.35	$2,072.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $642.88 / $865.16 / $1,302.20	Professional		$642.88	$865.16	$1,302.20