Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,163.39 / $1,163.39 / $1,163.39	Facility		$1,163.39	$1,163.39	$1,163.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $969.49 / $1,163.39 / $1,163.39	Professional		$969.49	$1,163.39	$1,163.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,083.34 / $6,143.20 / $11,188.79	Facility		$3,083.34	$6,143.20	$11,188.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,935.28 / $2,037.14 / $2,750.14	Professional		$1,935.28	$2,037.14	$2,750.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,292.39 / $1,324.14 / $1,331.31	Facility		$1,292.39	$1,324.14	$1,331.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,629.71 / $1,629.71 / $1,629.71	Professional		$1,629.71	$1,629.71	$1,629.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,317.79 / $1,317.79 / $1,317.79	Facility		$1,317.79	$1,317.79	$1,317.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,317.79 / $1,317.79 / $2,361.75	Professional		$1,317.79	$1,317.79	$2,361.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,163.39 / $1,472.12 / $1,472.12	Facility		$1,163.39	$1,472.12	$1,472.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,163.39 / $1,472.12 / $2,291.26	Professional		$1,163.39	$1,472.12	$2,291.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $756.58 / $973.88 / $1,439.90	Professional		$756.58	$973.88	$1,439.90