Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,179.13 / $1,179.13 / $1,179.13	Facility		$1,179.13	$1,179.13	$1,179.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $979.46 / $1,179.13 / $1,179.13	Professional		$979.46	$1,179.13	$1,179.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,125.07 / $6,226.34 / $11,340.21	Facility		$3,125.07	$6,226.34	$11,340.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,961.47 / $2,064.71 / $2,787.36	Professional		$1,961.47	$2,064.71	$2,787.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,309.90 / $1,342.06 / $1,349.30	Facility		$1,309.90	$1,342.06	$1,349.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,651.77 / $1,651.77 / $1,651.77	Professional		$1,651.77	$1,651.77	$1,651.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,335.63 / $1,335.63 / $1,335.63	Facility		$1,335.63	$1,335.63	$1,335.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,335.63 / $1,335.63 / $2,393.63	Professional		$1,335.63	$1,335.63	$2,393.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,179.13 / $1,492.05 / $1,492.05	Facility		$1,179.13	$1,492.05	$1,492.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,179.13 / $1,492.05 / $2,322.27	Professional		$1,179.13	$1,492.05	$2,322.27
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 $766.82 / $969.59 / $1,477.75	Professional		$766.82	$969.59	$1,477.75