Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,240.23 / $3,240.23 / $3,240.23	Facility		$3,240.23	$3,240.23	$3,240.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,417.84 / $3,240.23 / $3,240.23	Professional		$2,417.84	$3,240.23	$3,240.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,587.61 / $17,109.82 / $31,162.61	Facility		$8,587.61	$17,109.82	$31,162.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,390.08 / $5,673.77 / $7,659.59	Professional		$5,390.08	$5,673.77	$7,659.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,979.89 / $2,979.89 / $3,687.95	Facility		$2,979.89	$2,979.89	$3,687.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,539.02 / $4,539.02 / $4,539.02	Professional		$4,539.02	$4,539.02	$4,539.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,670.30 / $3,670.30 / $3,670.30	Facility		$3,670.30	$3,670.30	$3,670.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,670.30 / $3,670.30 / $6,577.50	Professional		$3,670.30	$3,670.30	$6,577.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $3,240.23 / $4,100.13 / $4,100.13	Facility		$3,240.23	$4,100.13	$4,100.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $3,240.23 / $4,100.13 / $5,957.45	Professional		$3,240.23	$4,100.13	$5,957.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,442.84 / $4,198.59 / $4,828.37	Professional		$3,442.84	$4,198.59	$4,828.37
United Facility/Professional Professional Modifier Low / Median / High Price $2,160.15 / $2,664.42 / $4,060.83	Professional		$2,160.15	$2,664.42	$4,060.83