Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,381.10 / $1,381.10 / $1,381.10	Facility		$1,381.10	$1,381.10	$1,381.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $985.24 / $1,381.10 / $1,381.10	Professional		$985.24	$1,381.10	$1,381.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,660.34 / $7,292.81 / $13,282.60	Facility		$3,660.34	$7,292.81	$13,282.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,297.44 / $2,418.36 / $3,264.79	Professional		$2,297.44	$2,418.36	$3,264.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,214.27 / $1,214.27 / $1,571.93	Facility		$1,214.27	$1,214.27	$1,571.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,934.69 / $1,934.69 / $1,934.69	Professional		$1,934.69	$1,934.69	$1,934.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,167.30 / $1,167.30 / $1,167.30	Facility		$1,167.30	$1,167.30	$1,167.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,167.30 / $1,167.30 / $2,803.50	Professional		$1,167.30	$1,167.30	$2,803.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,381.10 / $1,747.61 / $1,747.61	Facility		$1,381.10	$1,747.61	$1,747.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,381.10 / $1,747.61 / $2,539.27	Professional		$1,381.10	$1,747.61	$2,539.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,467.46 / $1,789.59 / $2,058.02	Professional		$1,467.46	$1,789.59	$2,058.02
United Facility/Professional Professional Modifier Low / Median / High Price $776.65 / $1,135.66 / $1,608.66	Professional		$776.65	$1,135.66	$1,608.66