Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,688.20 / $1,688.20 / $1,688.20	Facility		$1,688.20	$1,688.20	$1,688.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,330.88 / $1,688.20 / $1,688.20	Professional		$1,330.88	$1,688.20	$1,688.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,474.24 / $8,914.42 / $16,236.08	Facility		$4,474.24	$8,914.42	$16,236.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,808.29 / $2,956.10 / $3,990.74	Professional		$2,808.29	$2,956.10	$3,990.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,644.45 / $1,888.62 / $1,921.47	Facility		$1,644.45	$1,888.62	$1,921.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,364.88 / $2,364.88 / $2,364.88	Professional		$2,364.88	$2,364.88	$2,364.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,523.27 / $1,523.27 / $1,523.27	Facility		$1,523.27	$1,523.27	$1,523.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,523.27 / $1,523.27 / $3,427.13	Professional		$1,523.27	$1,523.27	$3,427.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,688.20 / $2,136.21 / $2,136.21	Facility		$1,688.20	$2,136.21	$2,136.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,688.20 / $2,136.21 / $3,324.85	Professional		$1,688.20	$2,136.21	$3,324.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $1,165.65	Professional		$30.00	$30.00	$1,165.65
United Facility/Professional Facility Modifier Low / Median / High Price $1,624.58 / $1,624.58 / $1,624.58	Facility		$1,624.58	$1,624.58	$1,624.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,013.49 / $1,413.20 / $1,978.57	Professional		$1,013.49	$1,413.20	$1,978.57