Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,739.32 / $1,739.32 / $1,739.32	Facility		$1,739.32	$1,739.32	$1,739.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,379.18 / $1,739.32 / $1,739.32	Professional		$1,379.18	$1,739.32	$1,739.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,609.72 / $9,184.34 / $16,727.71	Facility		$4,609.72	$9,184.34	$16,727.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,893.33 / $3,045.61 / $4,111.57	Professional		$2,893.33	$3,045.61	$4,111.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,631.99 / $1,757.57 / $1,979.65	Facility		$1,631.99	$1,757.57	$1,979.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,436.48 / $2,436.48 / $2,436.48	Professional		$2,436.48	$2,436.48	$2,436.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,119.51 / $2,119.51 / $2,119.51	Facility		$2,119.51	$2,119.51	$2,119.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,547.24 / $2,119.51 / $3,530.63	Professional		$1,547.24	$2,119.51	$3,530.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,739.32 / $2,200.90 / $2,200.90	Facility		$1,739.32	$2,200.90	$2,200.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,550.93 / $2,200.90 / $3,197.89	Professional		$1,550.93	$2,200.90	$3,197.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,915.68 / $2,253.75 / $2,591.81	Professional		$1,915.68	$2,253.75	$2,591.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,159.54 / $1,430.23 / $2,179.80	Professional		$1,159.54	$1,430.23	$2,179.80