Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,734.25 / $1,734.25 / $1,734.25	Facility		$1,734.25	$1,734.25	$1,734.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,218.30 / $1,734.25 / $1,734.25	Professional		$1,218.30	$1,734.25	$1,734.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,596.28 / $9,157.56 / $16,678.93	Facility		$4,596.28	$9,157.56	$16,678.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,884.89 / $3,036.73 / $4,099.59	Professional		$2,884.89	$3,036.73	$4,099.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,501.49 / $1,501.49 / $1,973.87	Facility		$1,501.49	$1,501.49	$1,973.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,429.38 / $2,429.38 / $2,429.38	Professional		$2,429.38	$2,429.38	$2,429.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,964.43 / $1,964.43 / $1,964.43	Facility		$1,964.43	$1,964.43	$1,964.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,964.43 / $1,964.43 / $3,520.50	Professional		$1,964.43	$1,964.43	$3,520.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,734.25 / $2,194.48 / $2,194.48	Facility		$1,734.25	$2,194.48	$2,194.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,718.24 / $2,194.48 / $3,188.56	Professional		$1,718.24	$2,194.48	$3,188.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,842.68 / $2,247.17 / $2,584.25	Professional		$1,842.68	$2,247.17	$2,584.25
United Facility/Professional Professional Modifier Low / Median / High Price $960.36 / $1,451.75 / $2,029.06	Professional		$960.36	$1,451.75	$2,029.06