Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,623.48 / $2,623.48 / $2,623.48	Facility		$2,623.48	$2,623.48	$2,623.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,108.80 / $2,623.48 / $2,623.48	Professional		$2,108.80	$2,623.48	$2,623.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3,445.37 / $3,445.37 / $3,445.37	Professional		$3,445.37	$3,445.37	$3,445.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,953.03 / $13,853.12 / $25,231.10	Facility		$6,953.03	$13,853.12	$25,231.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,364.13 / $4,593.82 / $6,201.66	Professional		$4,364.13	$4,593.82	$6,201.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,684.43 / $2,788.32 / $2,985.98	Facility		$2,684.43	$2,788.32	$2,985.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,675.06 / $3,675.06 / $3,675.06	Professional		$3,675.06	$3,675.06	$3,675.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,550.04 / $2,550.04 / $2,550.04	Facility		$2,550.04	$2,550.04	$2,550.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,550.04 / $2,550.04 / $5,325.75	Professional		$2,550.04	$2,550.04	$5,325.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,623.48 / $3,319.72 / $3,319.72	Facility		$2,623.48	$3,319.72	$3,319.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,448.58 / $3,319.72 / $4,823.51	Professional		$2,448.58	$3,319.72	$4,823.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,787.53 / $3,399.43 / $3,909.34	Professional		$2,787.53	$3,399.43	$3,909.34
United Facility/Professional Facility Modifier Low / Median / High Price $4,625.10 / $5,441.30 / $5,441.30	Facility		$4,625.10	$5,441.30	$5,441.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,696.63 / $2,196.14 / $3,229.01	Professional		$1,696.63	$2,196.14	$3,229.01