Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,729.62 / $1,729.62 / $1,729.62	Facility		$1,729.62	$1,729.62	$1,729.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,215.47 / $1,729.62 / $1,729.62	Professional		$1,215.47	$1,729.62	$1,729.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,584.02 / $9,133.14 / $16,634.45	Facility		$4,584.02	$9,133.14	$16,634.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,877.20 / $3,028.63 / $4,088.65	Professional		$2,877.20	$3,028.63	$4,088.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,546.08 / $1,693.44 / $1,968.61	Facility		$1,546.08	$1,693.44	$1,968.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,422.90 / $2,422.90 / $2,422.90	Professional		$2,422.90	$2,422.90	$2,422.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,486.28 / $1,486.28 / $1,486.28	Facility		$1,486.28	$1,486.28	$1,486.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,486.28 / $1,486.28 / $3,511.13	Professional		$1,486.28	$1,486.28	$3,511.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,729.62 / $2,188.63 / $2,188.63	Facility		$1,729.62	$2,188.63	$2,188.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,713.65 / $2,188.63 / $3,180.06	Professional		$1,713.65	$2,188.63	$3,180.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,837.77 / $2,241.19 / $2,577.36	Professional		$1,837.77	$2,241.19	$2,577.36
United Facility/Professional Facility Modifier Low / Median / High Price $1,428.89 / $1,428.89 / $1,428.89	Facility		$1,428.89	$1,428.89	$1,428.89
United Facility/Professional Professional Modifier Low / Median / High Price $988.88 / $1,447.88 / $2,014.60	Professional		$988.88	$1,447.88	$2,014.60