Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,430.61 / $1,430.61 / $1,430.61	Facility		$1,430.61	$1,430.61	$1,430.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,152.26 / $1,430.61 / $1,430.61	Professional		$1,152.26	$1,430.61	$1,430.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,791.55 / $7,554.23 / $13,758.74	Facility		$3,791.55	$7,554.23	$13,758.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,379.80 / $2,505.05 / $3,381.82	Professional		$2,379.80	$2,505.05	$3,381.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,347.52 / $1,420.11 / $1,628.28	Facility		$1,347.52	$1,420.11	$1,628.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,004.04 / $2,004.04 / $2,004.04	Professional		$2,004.04	$2,004.04	$2,004.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,295.39 / $1,295.39 / $1,295.39	Facility		$1,295.39	$1,295.39	$1,295.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,295.39 / $1,295.39 / $2,904.00	Professional		$1,295.39	$1,295.39	$2,904.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,430.61 / $1,810.26 / $1,810.26	Facility		$1,430.61	$1,810.26	$1,810.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,417.40 / $1,810.26 / $2,630.30	Professional		$1,417.40	$1,810.26	$2,630.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,520.06 / $1,853.74 / $2,131.80	Professional		$1,520.06	$1,853.74	$2,131.80
United Facility/Professional Professional Modifier Low / Median / High Price $861.88 / $1,197.57 / $1,723.75	Professional		$861.88	$1,197.57	$1,723.75