Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,654.48 / $2,654.48 / $2,654.48	Facility		$2,654.48	$2,654.48	$2,654.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,233.30 / $2,654.48 / $2,654.48	Professional		$2,233.30	$2,654.48	$2,654.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,035.21 / $14,016.84 / $25,529.28	Facility		$7,035.21	$14,016.84	$25,529.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,415.70 / $4,648.10 / $6,274.95	Professional		$4,415.70	$4,648.10	$6,274.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,710.23 / $2,960.39 / $3,021.27	Facility		$2,710.23	$2,960.39	$3,021.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,718.49 / $3,718.49 / $3,718.49	Professional		$3,718.49	$3,718.49	$3,718.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,006.81 / $3,006.81 / $3,006.81	Facility		$3,006.81	$3,006.81	$3,006.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,006.81 / $3,006.81 / $5,388.75	Professional		$3,006.81	$3,006.81	$5,388.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,654.48 / $3,358.94 / $3,358.94	Facility		$2,654.48	$3,358.94	$3,358.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,654.48 / $3,358.94 / $4,880.51	Professional		$2,654.48	$3,358.94	$4,880.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,820.47 / $3,439.60 / $3,955.54	Professional		$2,820.47	$3,439.60	$3,955.54
United Facility/Professional Professional Modifier Low / Median / High Price $1,733.47 / $2,222.09 / $3,326.74	Professional		$1,733.47	$2,222.09	$3,326.74