Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,417.98 / $1,417.98 / $1,417.98	Facility		$1,417.98	$1,417.98	$1,417.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,181.65 / $1,417.98 / $1,417.98	Professional		$1,181.65	$1,417.98	$1,417.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,758.09 / $7,487.55 / $13,637.30	Facility		$3,758.09	$7,487.55	$13,637.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,358.79 / $2,482.94 / $3,351.97	Professional		$2,358.79	$2,482.94	$3,351.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,357.14 / $1,546.29 / $1,613.91	Facility		$1,357.14	$1,546.29	$1,613.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,986.35 / $1,986.35 / $1,986.35	Professional		$1,986.35	$1,986.35	$1,986.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,606.19 / $1,606.19 / $1,606.19	Facility		$1,606.19	$1,606.19	$1,606.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,606.19 / $1,606.19 / $2,878.50	Professional		$1,606.19	$1,606.19	$2,878.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,417.98 / $1,794.30 / $1,794.30	Facility		$1,417.98	$1,794.30	$1,794.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,417.98 / $1,794.30 / $2,607.08	Professional		$1,417.98	$1,794.30	$2,607.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,506.65 / $1,837.38 / $2,112.98	Professional		$1,506.65	$1,837.38	$2,112.98
United Facility/Professional Professional Modifier Low / Median / High Price $868.03 / $1,166.00 / $1,659.04	Professional		$868.03	$1,166.00	$1,659.04