Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,290.82 / $3,290.82 / $3,290.82	Facility		$3,290.82	$3,290.82	$3,290.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,662.49 / $3,290.82 / $3,290.82	Professional		$2,662.49	$3,290.82	$3,290.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,721.69 / $17,376.97 / $31,649.19	Facility		$8,721.69	$17,376.97	$31,649.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,474.24 / $5,762.36 / $7,779.19	Professional		$5,474.24	$5,762.36	$7,779.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,549.30 / $3,586.34 / $3,745.53	Facility		$3,549.30	$3,586.34	$3,745.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,609.89 / $4,609.89 / $4,609.89	Professional		$4,609.89	$4,609.89	$4,609.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,728.42 / $3,728.42 / $3,728.42	Facility		$3,728.42	$3,728.42	$3,728.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,728.42 / $3,728.42 / $6,680.25	Professional		$3,728.42	$3,728.42	$6,680.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $3,290.82 / $4,164.14 / $4,164.14	Facility		$3,290.82	$4,164.14	$4,164.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $3,290.82 / $4,164.14 / $6,050.47	Professional		$3,290.82	$4,164.14	$6,050.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,135.42 / $2,754.78 / $4,326.12	Professional		$2,135.42	$2,754.78	$4,326.12