Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,773.41 / $2,773.41 / $2,773.41	Facility		$2,773.41	$2,773.41	$2,773.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,803.21 / $2,773.41 / $2,773.41	Professional		$1,803.21	$2,773.41	$2,773.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,350.39 / $14,644.81 / $26,673.02	Facility		$7,350.39	$14,644.81	$26,673.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,613.53 / $4,856.35 / $6,556.07	Professional		$4,613.53	$4,856.35	$6,556.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,390.28 / $2,509.69 / $3,156.63	Facility		$2,390.28	$2,509.69	$3,156.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,885.08 / $3,885.08 / $3,885.08	Professional		$3,885.08	$3,885.08	$3,885.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,141.52 / $3,141.52 / $3,141.52	Facility		$3,141.52	$3,141.52	$3,141.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,141.52 / $3,141.52 / $5,629.88	Professional		$3,141.52	$3,141.52	$5,629.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,773.41 / $3,509.41 / $3,509.41	Facility		$2,773.41	$3,509.41	$3,509.41
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,773.41 / $3,509.41 / $5,462.15	Professional		$2,773.41	$3,509.41	$5,462.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,946.83 / $3,593.70 / $4,132.75	Professional		$2,946.83	$3,593.70	$4,132.75
United Facility/Professional Professional Modifier Low / Median / High Price $1,514.24 / $2,321.64 / $3,230.37	Professional		$1,514.24	$2,321.64	$3,230.37