Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,270.41 / $2,270.41 / $2,270.41	Facility		$2,270.41	$2,270.41	$2,270.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,605.87 / $2,270.41 / $2,270.41	Professional		$1,605.87	$2,270.41	$2,270.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,017.29 / $11,988.76 / $21,835.48	Facility		$6,017.29	$11,988.76	$21,835.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,776.80 / $3,975.58 / $5,367.03	Professional		$3,776.80	$3,975.58	$5,367.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,996.09 / $2,264.85 / $2,584.13	Facility		$1,996.09	$2,264.85	$2,584.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,180.46 / $3,180.46 / $3,180.46	Professional		$3,180.46	$3,180.46	$3,180.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,571.77 / $2,571.77 / $2,571.77	Facility		$2,571.77	$2,571.77	$2,571.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,571.77 / $2,571.77 / $4,608.75	Professional		$2,571.77	$2,571.77	$4,608.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,270.41 / $2,872.94 / $2,872.94	Facility		$2,270.41	$2,872.94	$2,872.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,270.41 / $2,872.94 / $4,471.52	Professional		$2,270.41	$2,872.94	$4,471.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $1,192.47	Professional		$30.00	$30.00	$1,192.47
United Facility/Professional Professional Modifier Low / Median / High Price $1,276.70 / $1,900.58 / $2,656.38	Professional		$1,276.70	$1,900.58	$2,656.38