Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,689.83 / $1,689.83 / $4,413.47	Facility		$1,689.83	$1,689.83	$4,413.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,176.34 / $1,689.83 / $1,689.83	Professional		$1,176.34	$1,689.83	$1,689.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,219.21 / $2,219.21 / $2,219.21	Professional		$2,219.21	$2,219.21	$2,219.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,478.57 / $8,923.04 / $16,251.79	Facility		$4,478.57	$8,923.04	$16,251.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,811.01 / $2,958.96 / $3,994.60	Professional		$2,811.01	$2,958.96	$3,994.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,559.33 / $1,861.20 / $1,923.32	Facility		$1,559.33	$1,861.20	$1,923.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,367.17 / $2,367.17 / $2,367.17	Professional		$2,367.17	$2,367.17	$2,367.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $1,800.00 / $1,800.00	Facility		$1,800.00	$1,800.00	$1,800.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,800.00 / $1,800.00 / $3,430.50	Professional		$1,800.00	$1,800.00	$3,430.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,138.27 / $3,941.03 / $4,413.47	Facility		$2,138.27	$3,941.03	$4,413.47
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,689.83 / $2,138.27 / $3,328.07	Professional		$1,689.83	$2,138.27	$3,328.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $824.84	Professional		$30.00	$30.00	$824.84
United Facility/Professional Professional Modifier Low / Median / High Price $950.05 / $1,414.57 / $1,968.26	Professional		$950.05	$1,414.57	$1,968.26