Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,021.32 / $2,021.32 / $2,021.32	Facility		$2,021.32	$2,021.32	$2,021.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,521.72 / $2,021.32 / $2,021.32	Professional		$1,521.72	$2,021.32	$2,021.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,357.13 / $10,673.47 / $19,439.91	Facility		$5,357.13	$10,673.47	$19,439.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,362.45 / $3,539.42 / $4,778.22	Professional		$3,362.45	$3,539.42	$4,778.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,875.45 / $1,875.45 / $2,300.62	Facility		$1,875.45	$1,875.45	$2,300.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,831.54 / $2,831.54 / $2,831.54	Professional		$2,831.54	$2,831.54	$2,831.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,289.62 / $2,289.62 / $2,289.62	Facility		$2,289.62	$2,289.62	$2,289.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,671.42 / $2,942.96 / $5,129.06	Professional		$1,671.42	$2,942.96	$5,129.06
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,021.32 / $2,557.75 / $2,557.75	Facility		$2,021.32	$2,557.75	$2,557.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,802.39 / $2,557.75 / $3,716.39	Professional		$1,802.39	$2,557.75	$3,716.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,147.71 / $2,619.17 / $3,012.04	Professional		$2,147.71	$2,619.17	$3,012.04
United Facility/Professional Professional Modifier Low / Median / High Price $1,347.55 / $1,662.13 / $2,533.23	Professional		$1,347.55	$1,662.13	$2,533.23