Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,377.26 / $1,377.26 / $1,377.26	Facility		$1,377.26	$1,377.26	$1,377.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,147.72 / $1,377.26 / $1,377.26	Professional		$1,147.72	$1,377.26	$1,377.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,411.64 / $2,411.64 / $2,411.64	Professional		$2,411.64	$2,411.64	$2,411.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,650.17 / $7,272.54 / $13,245.69	Facility		$3,650.17	$7,272.54	$13,245.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,291.06 / $2,411.64 / $3,255.71	Professional		$2,291.06	$2,411.64	$3,255.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,530.01 / $1,567.57 / $1,576.06	Facility		$1,530.01	$1,567.57	$1,576.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,929.31 / $1,929.31 / $1,929.31	Professional		$1,929.31	$1,929.31	$1,929.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,346.19 / $1,346.19 / $1,346.19	Facility		$1,346.19	$1,346.19	$1,346.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,346.19 / $1,346.19 / $2,796.00	Professional		$1,346.19	$1,346.19	$2,796.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,377.26 / $1,742.76 / $1,742.76	Facility		$1,377.26	$1,742.76	$1,742.76
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,377.26 / $1,742.76 / $2,532.21	Professional		$1,377.26	$1,742.76	$2,532.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,463.38 / $1,784.61 / $2,052.30	Professional		$1,463.38	$1,784.61	$2,052.30
United Facility/Professional Professional Modifier Low / Median / High Price $895.67 / $1,152.92 / $1,704.63	Professional		$895.67	$1,152.92	$1,704.63