Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,718.93 / $1,718.93 / $1,718.93	Facility		$1,718.93	$1,718.93	$1,718.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,381.69 / $1,718.93 / $1,718.93	Professional		$1,381.69	$1,718.93	$1,718.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,555.68 / $9,076.68 / $16,531.63	Facility		$4,555.68	$9,076.68	$16,531.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,859.41 / $3,009.91 / $4,063.38	Professional		$2,859.41	$3,009.91	$4,063.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,780.13 / $1,826.92 / $1,956.44	Facility		$1,780.13	$1,826.92	$1,956.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,407.92 / $2,407.92 / $2,407.92	Professional		$2,407.92	$2,407.92	$2,407.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,711.28 / $1,711.28 / $1,711.28	Facility		$1,711.28	$1,711.28	$1,711.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,711.28 / $1,711.28 / $3,489.38	Professional		$1,711.28	$1,711.28	$3,489.38
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,718.93 / $2,175.09 / $2,175.09	Facility		$1,718.93	$2,175.09	$2,175.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,600.69 / $2,175.09 / $3,385.38	Professional		$1,600.69	$2,175.09	$3,385.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,826.41 / $2,227.33 / $2,561.42	Professional		$1,826.41	$2,227.33	$2,561.42
United Facility/Professional Professional Modifier Low / Median / High Price $1,138.58 / $1,438.93 / $2,154.25	Professional		$1,138.58	$1,438.93	$2,154.25