Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,661.72 / $1,661.72 / $1,661.72	Facility		$1,661.72	$1,661.72	$1,661.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,420.77 / $1,661.72 / $1,850.79	Professional		$1,420.77	$1,661.72	$1,850.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,404.08 / $8,774.61 / $15,981.46	Facility		$4,404.08	$8,774.61	$15,981.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,764.25 / $2,909.74 / $3,928.15	Professional		$2,764.25	$2,909.74	$3,928.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,856.38 / $1,891.33 / $1,926.47	Facility		$1,856.38	$1,891.33	$1,926.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,327.79 / $2,327.79 / $2,327.79	Professional		$2,327.79	$2,327.79	$2,327.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,050.41 / $2,050.41 / $2,050.41	Facility		$2,050.41	$2,050.41	$2,050.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,496.80 / $2,419.39 / $4,216.41	Professional		$1,496.80	$2,419.39	$4,216.41
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,661.72 / $2,102.69 / $2,102.69	Facility		$1,661.72	$2,102.69	$2,102.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,661.72 / $2,102.69 / $3,055.22	Professional		$1,661.72	$2,102.69	$3,055.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,765.63 / $2,153.21 / $2,476.19	Professional		$1,765.63	$2,153.21	$2,476.19
United Facility/Professional Professional Modifier Low / Median / High Price $1,187.34 / $1,424.81 / $2,195.59	Professional		$1,187.34	$1,424.81	$2,195.59