Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,014.34 / $1,014.34 / $1,014.34	Facility		$1,014.34	$1,014.34	$1,014.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $929.81 / $996.99 / $1,014.34	Professional		$929.81	$996.99	$1,014.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,332.11 / $1,332.11 / $1,332.11	Professional		$1,332.11	$1,332.11	$1,332.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,688.31 / $5,356.16 / $9,755.33	Facility		$2,688.31	$5,356.16	$9,755.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,687.34 / $1,776.15 / $2,397.80	Professional		$1,687.34	$1,776.15	$2,397.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,154.50 / $1,175.06 / $1,218.83	Facility		$1,154.50	$1,175.06	$1,218.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,420.92 / $1,420.92 / $1,420.92	Professional		$1,420.92	$1,420.92	$1,420.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,037.25 / $1,037.25 / $1,037.25	Facility		$1,037.25	$1,037.25	$1,037.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,037.25 / $1,037.25 / $2,059.13	Professional		$1,037.25	$1,037.25	$2,059.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,014.34 / $1,283.53 / $1,283.53	Facility		$1,014.34	$1,283.53	$1,283.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $996.99 / $1,283.53 / $1,864.95	Professional		$996.99	$1,283.53	$1,864.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,117.19 / $1,314.35 / $1,511.50	Professional		$1,117.19	$1,314.35	$1,511.50
United Facility/Professional Professional Modifier Low / Median / High Price $648.42 / $834.08 / $1,333.46	Professional		$648.42	$834.08	$1,333.46