Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,834.72 / $1,834.72 / $1,834.72	Facility		$1,834.72	$1,834.72	$1,834.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,233.27 / $1,834.72 / $1,834.72	Professional		$1,233.27	$1,834.72	$1,834.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,862.56 / $9,688.10 / $17,645.21	Facility		$4,862.56	$9,688.10	$17,645.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,052.03 / $3,212.66 / $4,337.09	Professional		$3,052.03	$3,212.66	$4,337.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,592.59 / $1,592.59 / $2,088.23	Facility		$1,592.59	$1,592.59	$2,088.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,570.13 / $2,570.13 / $2,570.13	Professional		$2,570.13	$2,570.13	$2,570.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,787.17 / $1,787.17 / $1,787.17	Facility		$1,787.17	$1,787.17	$1,787.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,304.63 / $2,671.27 / $4,655.63	Professional		$1,304.63	$2,671.27	$4,655.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,834.72 / $2,321.61 / $2,321.61	Facility		$1,834.72	$2,321.61	$2,321.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,635.99 / $2,321.61 / $3,373.29	Professional		$1,635.99	$2,321.61	$3,373.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,949.44 / $2,377.37 / $2,733.97	Professional		$1,949.44	$2,377.37	$2,733.97
United Facility/Professional Facility Modifier Low / Median / High Price $1,448.21 / $1,448.21 / $1,448.21	Facility		$1,448.21	$1,448.21	$1,448.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,018.62 / $1,535.86 / $2,137.02	Professional		$1,018.62	$1,535.86	$2,137.02