Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,758.52 / $2,758.52 / $2,758.52	Facility		$2,758.52	$2,758.52	$2,758.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,298.77 / $2,758.52 / $2,758.52	Professional		$2,298.77	$2,758.52	$2,758.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,310.94 / $14,566.22 / $26,529.88	Facility		$7,310.94	$14,566.22	$26,529.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,588.78 / $4,830.29 / $6,520.89	Professional		$4,588.78	$4,830.29	$6,520.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,064.41 / $3,139.69 / $3,156.69	Facility		$3,064.41	$3,139.69	$3,156.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,864.23 / $3,864.23 / $3,864.23	Professional		$3,864.23	$3,864.23	$3,864.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,886.72 / $2,886.72 / $2,886.72	Facility		$2,886.72	$2,886.72	$2,886.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,886.72 / $2,886.72 / $5,599.88	Professional		$2,886.72	$2,886.72	$5,599.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,758.52 / $3,490.60 / $3,490.60	Facility		$2,758.52	$3,490.60	$3,490.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,758.52 / $3,490.60 / $5,432.85	Professional		$2,758.52	$3,490.60	$5,432.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.81 / $30.00 / $30.00	Professional		$6.81	$30.00	$30.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,890.35 / $5,753.36 / $5,753.36	Facility		$4,890.35	$5,753.36	$5,753.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,793.93 / $2,404.42 / $3,457.14	Professional		$1,793.93	$2,404.42	$3,457.14