Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,259.92 / $1,259.92 / $1,259.92	Facility		$1,259.92	$1,259.92	$1,259.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $811.35 / $1,259.92 / $1,259.92	Professional		$811.35	$1,259.92	$1,259.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,339.16 / $6,652.90 / $12,117.11	Facility		$3,339.16	$6,652.90	$12,117.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,095.85 / $2,206.16 / $2,978.32	Professional		$2,095.85	$2,206.16	$2,978.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,075.50 / $1,075.50 / $1,434.00	Facility		$1,075.50	$1,075.50	$1,434.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,764.93 / $1,764.93 / $1,764.93	Professional		$1,764.93	$1,764.93	$1,764.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,427.14 / $1,427.14 / $1,427.14	Facility		$1,427.14	$1,427.14	$1,427.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,427.14 / $1,427.14 / $2,557.50	Professional		$1,427.14	$1,427.14	$2,557.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,259.92 / $1,594.28 / $1,594.28	Facility		$1,259.92	$1,594.28	$1,594.28
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,248.28 / $1,594.28 / $2,316.46	Professional		$1,248.28	$1,594.28	$2,316.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,338.69 / $1,632.56 / $1,877.44	Professional		$1,338.69	$1,632.56	$1,877.44
United Facility/Professional Professional Modifier Low / Median / High Price $687.90 / $1,054.69 / $1,474.10	Professional		$687.90	$1,054.69	$1,474.10