Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,505.30 / $2,505.30 / $2,505.30	Facility		$2,505.30	$2,505.30	$2,505.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,087.75 / $2,505.30 / $2,505.30	Professional		$2,087.75	$2,505.30	$2,505.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,639.82 / $13,229.08 / $24,094.50	Facility		$6,639.82	$13,229.08	$24,094.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,167.54 / $4,386.88 / $5,922.29	Professional		$4,167.54	$4,386.88	$5,922.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,783.14 / $2,851.47 / $2,866.96	Facility		$2,783.14	$2,851.47	$2,866.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,509.50 / $3,509.50 / $3,509.50	Professional		$3,509.50	$3,509.50	$3,509.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,448.80 / $2,448.80 / $2,448.80	Facility		$2,448.80	$2,448.80	$2,448.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,448.80 / $2,448.80 / $5,085.75	Professional		$2,448.80	$2,448.80	$5,085.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,505.30 / $3,170.16 / $3,170.16	Facility		$2,505.30	$3,170.16	$3,170.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,505.30 / $3,170.16 / $4,934.13	Professional		$2,505.30	$3,170.16	$4,934.13
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 Professional Modifier Low / Median / High Price $1,629.27 / $2,097.19 / $3,100.81	Professional		$1,629.27	$2,097.19	$3,100.81