Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,189.23 / $2,189.23 / $2,189.23	Facility		$2,189.23	$2,189.23	$2,189.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,638.68 / $2,189.23 / $2,189.23	Professional		$1,638.68	$2,189.23	$2,189.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,802.17 / $11,560.15 / $21,054.84	Facility		$5,802.17	$11,560.15	$21,054.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,641.78 / $3,833.45 / $5,175.16	Professional		$3,641.78	$3,833.45	$5,175.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,019.60 / $2,019.60 / $2,491.73	Facility		$2,019.60	$2,019.60	$2,491.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,066.76 / $3,066.76 / $3,066.76	Professional		$3,066.76	$3,066.76	$3,066.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,479.82 / $2,479.82 / $2,479.82	Facility		$2,479.82	$2,479.82	$2,479.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,479.82 / $2,479.82 / $4,444.13	Professional		$2,479.82	$2,479.82	$4,444.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,189.23 / $2,770.23 / $2,770.23	Facility		$2,189.23	$2,770.23	$2,770.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,189.23 / $2,770.23 / $4,025.12	Professional		$2,189.23	$2,770.23	$4,025.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,326.13 / $2,836.75 / $3,262.26	Professional		$2,326.13	$2,836.75	$3,262.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,291.74 / $1,832.64 / $2,561.41	Professional		$1,291.74	$1,832.64	$2,561.41