Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,506.08 / $2,506.08 / $2,506.08	Facility		$2,506.08	$2,506.08	$2,506.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,088.40 / $2,506.08 / $2,506.08	Professional		$2,088.40	$2,506.08	$2,506.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,641.89 / $13,233.21 / $24,102.02	Facility		$6,641.89	$13,233.21	$24,102.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,168.84 / $4,388.25 / $5,924.14	Professional		$4,168.84	$4,388.25	$5,924.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,595.73 / $2,852.36 / $2,853.66	Facility		$2,595.73	$2,852.36	$2,853.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,510.60 / $3,510.60 / $3,510.60	Professional		$3,510.60	$3,510.60	$3,510.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,728.17 / $2,728.17 / $2,728.17	Facility		$2,728.17	$2,728.17	$2,728.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,991.56 / $3,648.74 / $6,359.06	Professional		$1,991.56	$3,648.74	$6,359.06
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,506.08 / $3,171.14 / $3,171.14	Facility		$2,506.08	$3,171.14	$3,171.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,506.08 / $3,171.14 / $4,607.66	Professional		$2,506.08	$3,171.14	$4,607.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,662.79 / $3,247.31 / $3,734.40	Professional		$2,662.79	$3,247.31	$3,734.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,648.40 / $2,097.86 / $3,137.22	Professional		$1,648.40	$2,097.86	$3,137.22