Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.15 / $2,951.15 / $2,951.15	Facility		$2,951.15	$2,951.15	$2,951.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,095.51 / $2,951.15 / $2,951.15	Professional		$2,095.51	$2,951.15	$2,951.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,821.47 / $15,583.38 / $28,382.47	Facility		$7,821.47	$15,583.38	$28,382.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,909.21 / $5,167.59 / $6,976.25	Professional		$4,909.21	$5,167.59	$6,976.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,739.67 / $2,739.67 / $3,358.93	Facility		$2,739.67	$2,739.67	$3,358.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,134.07 / $4,134.07 / $4,134.07	Professional		$4,134.07	$4,134.07	$4,134.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,249.00 / $3,249.00 / $3,249.00	Facility		$3,249.00	$3,249.00	$3,249.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,249.00 / $3,249.00 / $5,990.63	Professional		$3,249.00	$3,249.00	$5,990.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,951.15 / $3,734.35 / $3,734.35	Facility		$2,951.15	$3,734.35	$3,734.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,951.15 / $3,734.35 / $5,425.96	Professional		$2,951.15	$3,734.35	$5,425.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,135.69 / $3,824.02 / $4,397.62	Professional		$3,135.69	$3,824.02	$4,397.62
United Facility/Professional Professional Modifier Low / Median / High Price $1,752.30 / $2,470.44 / $3,698.55	Professional		$1,752.30	$2,470.44	$3,698.55