Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.50 / $1,412.50 / $1,412.50	Facility		$1,412.50	$1,412.50	$1,412.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,177.08 / $1,412.50 / $1,412.50	Professional		$1,177.08	$1,412.50	$1,412.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,855.01 / $2,473.35 / $2,473.35	Professional		$1,855.01	$2,473.35	$2,473.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,743.57 / $7,458.63 / $13,584.63	Facility		$3,743.57	$7,458.63	$13,584.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,349.67 / $2,473.35 / $3,339.02	Professional		$2,349.67	$2,473.35	$3,339.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,412.05 / $1,477.81 / $1,607.68	Facility		$1,412.05	$1,477.81	$1,607.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,978.68 / $1,978.68 / $1,978.68	Professional		$1,978.68	$1,978.68	$1,978.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,599.98 / $1,599.98 / $1,599.98	Facility		$1,599.98	$1,599.98	$1,599.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,599.98 / $1,599.98 / $2,867.25	Professional		$1,599.98	$1,599.98	$2,867.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,412.50 / $1,787.36 / $1,787.36	Facility		$1,412.50	$1,787.36	$1,787.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,304.74 / $1,787.36 / $2,597.01	Professional		$1,304.74	$1,787.36	$2,597.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.82 / $1,830.28 / $2,104.82	Professional		$1,500.82	$1,830.28	$2,104.82
United Facility/Professional Professional Modifier Low / Median / High Price $903.15 / $1,182.43 / $1,748.07	Professional		$903.15	$1,182.43	$1,748.07