Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,560.44 / $2,560.44 / $2,560.44	Facility		$2,560.44	$2,560.44	$2,560.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,133.71 / $2,560.44 / $2,560.44	Professional		$2,133.71	$2,560.44	$2,560.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,785.98 / $13,520.29 / $24,624.90	Facility		$6,785.98	$13,520.29	$24,624.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,259.28 / $4,483.45 / $6,052.66	Professional		$4,259.28	$4,483.45	$6,052.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,844.35 / $2,914.24 / $2,930.03	Facility		$2,844.35	$2,914.24	$2,930.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,586.76 / $3,586.76 / $3,586.76	Professional		$3,586.76	$3,586.76	$3,586.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,502.67 / $2,502.67 / $2,502.67	Facility		$2,502.67	$2,502.67	$2,502.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,502.67 / $2,502.67 / $5,197.50	Professional		$2,502.67	$2,502.67	$5,197.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,560.44 / $3,239.95 / $3,239.95	Facility		$2,560.44	$3,239.95	$3,239.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,560.44 / $3,239.95 / $5,042.75	Professional		$2,560.44	$3,239.95	$5,042.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $486.70	Professional		$30.00	$30.00	$486.70
United Facility/Professional Professional Modifier Low / Median / High Price $1,665.11 / $2,143.37 / $3,208.90	Professional		$1,665.11	$2,143.37	$3,208.90