Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,099.94 / $1,099.94 / $1,099.94	Facility		$1,099.94	$1,099.94	$1,099.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $708.34 / $1,099.94 / $1,099.94	Professional		$708.34	$1,099.94	$1,099.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,915.20 / $5,808.20 / $10,578.64	Facility		$2,915.20	$5,808.20	$10,578.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,829.75 / $1,926.05 / $2,600.17	Professional		$1,829.75	$1,926.05	$2,600.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $938.95 / $1,062.44 / $1,251.93	Facility		$938.95	$1,062.44	$1,251.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,540.84 / $1,540.84 / $1,540.84	Professional		$1,540.84	$1,540.84	$1,540.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $902.63 / $902.63 / $902.63	Facility		$902.63	$902.63	$902.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $902.63 / $902.63 / $2,232.75	Professional		$902.63	$902.63	$2,232.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,099.94 / $1,391.86 / $1,391.86	Facility		$1,099.94	$1,391.86	$1,391.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,099.94 / $1,391.86 / $2,166.32	Professional		$1,099.94	$1,391.86	$2,166.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $682.99	Professional		$30.00	$30.00	$682.99
United Facility/Professional Professional Modifier Low / Median / High Price $651.35 / $920.77 / $1,281.18	Professional		$651.35	$920.77	$1,281.18