Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,328.67 / $2,328.67 / $2,328.67	Facility		$2,328.67	$2,328.67	$2,328.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,625.57 / $2,328.67 / $2,328.67	Professional		$1,625.57	$2,328.67	$2,328.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,171.72 / $12,296.44 / $22,395.87	Facility		$6,171.72	$12,296.44	$22,395.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,873.73 / $4,077.61 / $5,504.77	Professional		$3,873.73	$4,077.61	$5,504.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,154.80 / $2,154.80 / $2,650.45	Facility		$2,154.80	$2,154.80	$2,650.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,262.09 / $3,262.09 / $3,262.09	Professional		$3,262.09	$3,262.09	$3,262.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,637.76 / $2,637.76 / $2,637.76	Facility		$2,637.76	$2,637.76	$2,637.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,637.76 / $2,637.76 / $4,727.25	Professional		$2,637.76	$2,637.76	$4,727.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,328.67 / $2,946.67 / $2,946.67	Facility		$2,328.67	$2,946.67	$2,946.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,307.17 / $2,946.67 / $4,281.49	Professional		$2,307.17	$2,946.67	$4,281.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,474.29 / $3,017.43 / $3,470.04	Professional		$2,474.29	$3,017.43	$3,470.04
United Facility/Professional Professional Modifier Low / Median / High Price $1,494.78 / $1,949.36 / $2,881.89	Professional		$1,494.78	$1,949.36	$2,881.89