Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,713.74 / $1,713.74 / $1,713.74	Facility		$1,713.74	$1,713.74	$1,713.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.48 / $1,713.74 / $1,713.74	Professional		$1,202.48	$1,713.74	$1,713.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,541.93 / $9,049.27 / $16,481.70	Facility		$4,541.93	$9,049.27	$16,481.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,850.78 / $3,000.82 / $4,051.11	Professional		$2,850.78	$3,000.82	$4,051.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,482.00 / $1,482.00 / $1,950.53	Facility		$1,482.00	$1,482.00	$1,950.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,400.66 / $2,400.66 / $2,400.66	Professional		$2,400.66	$2,400.66	$2,400.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,424.68 / $1,424.68 / $1,424.68	Facility		$1,424.68	$1,424.68	$1,424.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,040.02 / $2,495.13 / $4,348.59	Professional		$1,040.02	$2,495.13	$4,348.59
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,713.74 / $2,168.53 / $2,168.53	Facility		$1,713.74	$2,168.53	$2,168.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,693.40 / $2,168.53 / $3,150.86	Professional		$1,693.40	$2,168.53	$3,150.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,820.90 / $2,220.61 / $2,553.70	Professional		$1,820.90	$2,220.61	$2,553.70
United Facility/Professional Professional Modifier Low / Median / High Price $947.89 / $1,434.58 / $1,996.10	Professional		$947.89	$1,434.58	$1,996.10