Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,214.08 / $1,214.08 / $1,214.08	Facility		$1,214.08	$1,214.08	$1,214.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $921.58 / $1,214.08 / $1,214.08	Professional		$921.58	$1,214.08	$1,214.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,217.68 / $6,410.86 / $11,676.29	Facility		$3,217.68	$6,410.86	$11,676.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,019.61 / $2,125.90 / $2,869.97	Professional		$2,019.61	$2,125.90	$2,869.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,135.81 / $1,135.81 / $1,381.84	Facility		$1,135.81	$1,135.81	$1,381.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,700.72 / $1,700.72 / $1,700.72	Professional		$1,700.72	$1,700.72	$1,700.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,375.24 / $1,375.24 / $1,375.24	Facility		$1,375.24	$1,375.24	$1,375.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,375.24 / $1,375.24 / $2,464.50	Professional		$1,375.24	$1,375.24	$2,464.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,214.08 / $1,536.28 / $1,536.28	Facility		$1,214.08	$1,536.28	$1,536.28
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,214.08 / $1,536.28 / $2,232.19	Professional		$1,214.08	$1,536.28	$2,232.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,337.19 / $1,573.17 / $1,809.14	Professional		$1,337.19	$1,573.17	$1,809.14
United Facility/Professional Professional Modifier Low / Median / High Price $726.47 / $1,016.31 / $1,420.48	Professional		$726.47	$1,016.31	$1,420.48