Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,938.74 / $1,938.74 / $1,938.74	Facility		$1,938.74	$1,938.74	$1,938.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,434.62 / $1,938.74 / $1,938.74	Professional		$1,434.62	$1,938.74	$1,938.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,138.26 / $10,237.39 / $18,645.65	Facility		$5,138.26	$10,237.39	$18,645.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,225.07 / $3,394.81 / $4,582.99	Professional		$3,225.07	$3,394.81	$4,582.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,840.36 / $1,840.36 / $2,206.63	Facility		$1,840.36	$1,840.36	$2,206.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,715.85 / $2,715.85 / $2,715.85	Professional		$2,715.85	$2,715.85	$2,715.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,769.18 / $1,769.18 / $1,769.18	Facility		$1,769.18	$1,769.18	$1,769.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,769.17 / $1,769.18 / $3,935.63	Professional		$1,769.17	$1,769.18	$3,935.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,938.74 / $2,453.23 / $2,453.23	Facility		$1,938.74	$2,453.23	$2,453.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,920.83 / $2,453.23 / $3,564.55	Professional		$1,920.83	$2,453.23	$3,564.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,059.97 / $2,512.16 / $2,888.98	Professional		$2,059.97	$2,512.16	$2,888.98
United Facility/Professional Professional Modifier Low / Median / High Price $1,177.09 / $1,611.65 / $2,268.29	Professional		$1,177.09	$1,611.65	$2,268.29