Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,688.58 / $2,688.58 / $2,688.58	Facility		$2,688.58	$2,688.58	$2,688.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,161.14 / $2,688.58 / $2,688.58	Professional		$2,161.14	$2,688.58	$2,688.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,125.55 / $14,196.84 / $25,857.12	Facility		$7,125.55	$14,196.84	$25,857.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,472.41 / $4,707.80 / $6,355.53	Professional		$4,472.41	$4,707.80	$6,355.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,737.22 / $2,857.53 / $3,060.07	Facility		$2,737.22	$2,857.53	$3,060.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,766.24 / $3,766.24 / $3,766.24	Professional		$3,766.24	$3,766.24	$3,766.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,364.97 / $3,364.97 / $3,364.97	Facility		$3,364.97	$3,364.97	$3,364.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,364.97 / $3,364.97 / $5,457.75	Professional		$3,364.97	$3,364.97	$5,457.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,688.58 / $3,402.09 / $3,402.09	Facility		$2,688.58	$3,402.09	$3,402.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,688.58 / $3,402.09 / $5,295.08	Professional		$2,688.58	$3,402.09	$5,295.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $1,299.17	Professional		$30.00	$30.00	$1,299.17
United Facility/Professional Professional Modifier Low / Median / High Price $1,691.28 / $2,250.63 / $3,369.48	Professional		$1,691.28	$2,250.63	$3,369.48