Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,562.05 / $1,562.05 / $1,562.05	Facility		$1,562.05	$1,562.05	$1,562.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,279.08 / $1,562.05 / $1,562.05	Professional		$1,279.08	$1,562.05	$1,562.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,139.93 / $8,248.33 / $15,022.92	Facility		$4,139.93	$8,248.33	$15,022.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,598.46 / $2,735.22 / $3,692.55	Professional		$2,598.46	$2,735.22	$3,692.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,576.42 / $1,576.42 / $1,777.89	Facility		$1,576.42	$1,576.42	$1,777.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,188.17 / $2,188.17 / $2,188.17	Professional		$2,188.17	$2,188.17	$2,188.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,769.38 / $1,769.38 / $1,769.38	Facility		$1,769.38	$1,769.38	$1,769.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,769.38 / $1,769.38 / $3,171.00	Professional		$1,769.38	$1,769.38	$3,171.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,562.05 / $1,976.59 / $1,976.59	Facility		$1,562.05	$1,976.59	$1,976.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,562.05 / $1,976.59 / $2,871.98	Professional		$1,562.05	$1,976.59	$2,871.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,720.45 / $2,024.06 / $2,327.66	Professional		$1,720.45	$2,024.06	$2,327.66
United Facility/Professional Professional Modifier Low / Median / High Price $1,008.28 / $1,307.59 / $1,918.95	Professional		$1,008.28	$1,307.59	$1,918.95