Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,389.19 / $1,389.19 / $1,389.19	Facility		$1,389.19	$1,389.19	$1,389.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $894.60 / $1,389.19 / $1,389.19	Professional		$894.60	$1,389.19	$1,389.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,681.77 / $7,335.51 / $13,360.37	Facility		$3,681.77	$7,335.51	$13,360.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,310.89 / $2,432.52 / $3,283.90	Professional		$2,310.89	$2,432.52	$3,283.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,185.84 / $1,301.99 / $1,581.14	Facility		$1,185.84	$1,301.99	$1,581.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,946.02 / $1,946.02 / $1,946.02	Professional		$1,946.02	$1,946.02	$1,946.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,573.58 / $1,573.58 / $1,573.58	Facility		$1,573.58	$1,573.58	$1,573.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,573.58 / $1,573.58 / $2,820.00	Professional		$1,573.58	$1,573.58	$2,820.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,389.19 / $1,757.86 / $1,757.86	Facility		$1,389.19	$1,757.86	$1,757.86
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,389.19 / $1,757.86 / $2,735.96	Professional		$1,389.19	$1,757.86	$2,735.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $872.34	Professional		$30.00	$30.00	$872.34
United Facility/Professional Facility Modifier Low / Median / High Price $1,261.08 / $1,261.08 / $1,261.08	Facility		$1,261.08	$1,261.08	$1,261.08
United Facility/Professional Professional Modifier Low / Median / High Price $758.48 / $1,162.90 / $1,625.34	Professional		$758.48	$1,162.90	$1,625.34