Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,218.69 / $2,218.69 / $2,218.69	Facility		$2,218.69	$2,218.69	$2,218.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,607.11 / $2,218.69 / $2,218.69	Professional		$1,607.11	$2,218.69	$2,218.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,880.24 / $11,715.70 / $21,338.14	Facility		$5,880.24	$11,715.70	$21,338.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,690.78 / $3,885.03 / $5,244.79	Professional		$3,690.78	$3,885.03	$5,244.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,094.98 / $2,230.00 / $2,525.27	Facility		$2,094.98	$2,230.00	$2,525.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,108.02 / $3,108.02 / $3,108.02	Professional		$3,108.02	$3,108.02	$3,108.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,561.34 / $2,561.34 / $2,561.34	Facility		$2,561.34	$2,561.34	$2,561.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,561.34 / $2,561.34 / $4,503.75	Professional		$2,561.34	$2,561.34	$4,503.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,218.69 / $2,807.51 / $2,807.51	Facility		$2,218.69	$2,807.51	$2,807.51
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,198.21 / $2,807.51 / $4,079.28	Professional		$2,198.21	$2,807.51	$4,079.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,357.43 / $2,874.92 / $3,306.15	Professional		$2,357.43	$2,874.92	$3,306.15
United Facility/Professional Professional Modifier Low / Median / High Price $1,339.96 / $1,857.29 / $2,595.88	Professional		$1,339.96	$1,857.29	$2,595.88